Important! An update has been made to the information contained on this web page. This page has been retained for archival purposes only. Please refer to our Upcoming System and Process Changes archive page for the latest information.

   >> Upcoming System and Process Changes: Complete Communication Archive

NaviNet and AmeriHealth are receiving a number of inquiries related to the referral transaction that went live October 26, 2013. Please review the user guides and webinars posted to the NaviNet Transaction Changes section of our Upcoming System and Process Changes site to orient yourself to the new transaction before contacting NaviNet or AmeriHealth Customer Service.

We understand that some providers may still have unresolved problems with issuing referrals. We appreciate your patience as we continue to address outstanding issues. Please keep in mind that referrals can be retroactively issued for 90 days from the date of service.

Referral inquiry update

• Name and member ID search capability has been restored based on end user feedback.

Referral submission update

• At the present time, when searching for a professional specialist to refer to, you must conduct a search by individual provider from the group practice. Provider's last name is required and at least one of the following fields: first name, billing provider NPI, billing provider number, specialty, city, or ZIP code. You do not have the ability to conduct a solo search by Provider Group or NPI. If you have difficulty identifying an individual provider within a group, you may either call the specialist you are referring to or use the Provider Finder tool on the AmeriHealth website. Please note: This functionality is under review for enhancement. Please continue to check the AmeriHealth News and Announcements section of Plan Central for additional updates.
• For a facility search, you must enter the facility name or facility NPI. Optionally, you can also enter specialty, city, and/or ZIP code to narrow the search.
• If your provider name is not populated in the NaviNet drop down, please be aware that this issue has been reported and is under investigation. If you are unable to issue a referral, please note that you must hold the referral until this issue is resolved. Referrals can be retroactively issued for up to 90 days from the date of service.
• If you are attempting to issue a referral, please note that some service types offered though referral submission, such as radiology and fracture care, are temporarily unavailable. Please use medical care (consult and treat) until this information has been restored, which is expected to be within the next 48 hours.

Referral retrieval update

• We ask that specialists maintain flexibility with Primary Care Offices, which may be experiencing referral submission issues. You may contact the Primary Care Office to confirm referral status in the event of immediate patient care needs.

If you need assistance, please contact the eBusiness hotline at 215-640-7410 for Pennsylvania and Delaware providers or 609-662-2565 for New Jersey providers. Please do not make multiple calls to this hotline. We will return your call as soon as possible.

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