In mid-October, when creating a new referral, primary care physicians (PCP) will see some changes to the submissionscreens when searching for a member on the NaviNet web portal.

Patient Search

When searching for a member, PCPs willhave several options available:

• Member ID (as it appears on the member?sID card)
• Member ID and member last name andfirst name
• Member ID and member date of birth
• Member last name, first name, anddate of birth

 

 

Patient Search Results

The Patient Search Results screen indicatesthe following details about the patient:

• Member ID (without an alpha prefix)
• Patient name
• Date of birth
• Gender
• Address
• Product/line of business (e.g., Comprehensive, Facility, HMO, Major Medical, PPO, POS, Professional)
  Note: If a member is covered under more than one medical product, the summary screen will display aconcatenated product name
• Coverage date span
• Status (only active member coverage for the selected date of service will display)

 

You can download the user guide for this new transaction later this month in the NaviNet Resources section ofour Provider News Center. If you have any questions about any NaviNettransactions, please call the eBusiness Hotline at 609-662-2565 for AmeriHealth New Jersey or at 215-640-7410 forAmeriHealth Pennsylvania.

NaviNet is a registered trademark of NaviNet, Inc.