NaviNet® web portal (NaviNet Open)
Independence Blue Cross offers network providers a way to simplify health care administration through NaviNet Open.
NaviNet Open gives providers fast, secure, HIPAA-compliant access to provider and member information, and enables real-time transactions. Best of all, NaviNet Open is free and requires no additional software.
Information at your fingertips
- Eligibility and benefits. Determine a patient’s plan type, their primary care physician (HMO only), capitated sites (when applicable), coverage dates, copayments, etc., for local and out-of-area Blue Plan members.
- Claims data. Retrieve up to 18 months of historic claims data (including paid, denied, and in-process/pended claims).
- Clinical alerts. Receive patient-specific preventive care reminders for due, or past due, services (professional and facility providers only).
- Clinical care reports. Get a quick snapshot of the care that patients have received based on Independence-paid medical and prescription drug claims.
- Authorization status. Review the status of inpatient, outpatient, and concurrent reviews.
- Referrals. Retrieve electronic referrals (within 365 days of the referral date).
- Explanation of Benefits and Remittance. Don’t wait to receive paper — review your Provider EOB or Remittance online.
- Capitation rosters. Access up-to-date rosters of your assigned HMO members.
- Code inquiries. Perform code-to-English/English-to-code procedure and diagnosis code inquiries.
- Cash management. Allows users to access a weekly summation of estimated payments and offsets by the health plan, as well as provide a summary of payments for the current six-month period.
- Claims dashboard. Access to a comprehensive dashboard of all pended and finalized claims.
- Document exchange. Document Exchange allows Independence Blue Cross to share more information electronically with our providers through NaviNet Open. NaviNet Open security officers control access to this transaction.
Submit information quickly through NaviNet Open
- Authorization requests. Submit authorization requests for inpatient and outpatient procedures, home health care, home infusion care, and durable medical equipment. Edit service dates for approved authorizations for select service types (when appropriate).
Note: This includes requests for extensions to approved authorizations, the addition of new services to already existing approved authorizations, and new services not associated with existing approved authorizations.
- Adjustments to claims. Submit claim review requests/claim investigations for finalized claims.
- Electronic payments. Easily submit a one-time application for Electronic Funds Transfer (EFT) for claim payments.
- Referrals. Submit electronic referrals to Independence and to NaviNet Open-enabled specialists and facilities.
- Encounters. Report covered services performed by PCPs that are part of the PCP capitation arrangement with the plan (for use by PCPs only).
- Emergency admissions. Submit notification of emergency admissions (for use by hospitals only).
Visit the NaviNet Open section of our Provider News Center to view detailed user guides for many of our NaviNet Open transactions.
What are the requirements for NaviNet Open registration?
You must be an Independence-participating provider.
Technical requirements include:
- Windows 7 (or more recent) Microsoft operating system;
- Internet connection (high-speed recommended; minimum 56k dial-up speed);
- Internet Explorer 11 web browser on Windows 7, Mozilla Firefox (latest version), or Google Chrome (latest version).
NaviNet® is a registered trademark of NantHealth, an independent company.