As previously communicated, providers must use the NaviNet? web portal or the Provider Automated System when requesting member eligibility.

In addition, providers must use NaviNet or call the Provider Automated System to check claims status information. The claim detail provided through either system includes specific information, such as check date, check number, service codes, paid amount, and member responsibility.

Providers can view a webinar for more information on these requirements. The presentation offers guidance on where to obtain member eligibility and claims status information through NaviNet. If your office is currently NaviNet-enabled and would like assistance with accessing member or claims information, please call the eBusiness Provider Hotline at 215-640-7410 for providers in Pennsylvania and Delaware or 609-662-2565 for providers in New Jersey.

Providers without access to NaviNet must obtain eligibility and claims status information through the Provider Automated System by calling 1-800-275-2583 and following the voice prompts. Note: Per upcoming NaviNet requirements, you must register by April 1, 2013. To register, please visit NaviNet and select Sign Up from the top right.

NaviNet^® is a registered trademark of NaviNet, Inc.