We are pleased to announce that the Provider File Management transaction on the NaviNet web portal is now available to accept submissions. This transaction allows professional providers to view and submit specific updates to their AmeriHealth provider record.
Note: The Provider File Management transaction is not intended for use by facilities, skilled nursing facilities, ancillary providers, or providers contracted with Magellan Healthcare, Inc. (Magellan)*.
Professional providers can initiate the following updates as it relates to their practice:
- Add/Delete a participating practitioner to/from an existing practice
- Add/Delete an address (i.e., doing business as [DBA], check, mailing, main, or practice)
- Add/Delete contact name, title, or communication device type/number
- Add/Delete office hours
- Update ?Walk-in? acceptance status
- Update Patient and Appointment Options (i.e., accepting new patients)
- Update General Practice Availability (i.e., Urgent, Routine Visits, etc.)
- Update Member Access number (i.e., the telephone number that appears on the member's identification card – which must be the location-specific telephone number for a patient to make an appointment)
- Update Electronic Medical Records (EMR) status
- Update the availability of other clinical staff (i.e., mid-wife, nurse practitioner, etc.)
- Update office accessibility and services (i.e., handicapped, parking, and communication and language services)
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We have created a
Provider File Management Guide to assist you in navigating this transaction and ensure accurate submissions. The guide is now available in the
NaviNet Resources section.
More information
Updates on the upcoming self-service requirements will be communicated in a future Partners in Health UpdateSM article.
If you have any further questions on this transaction, please contact the eBusiness Hotline at 609-662-2565 for AmeriHealth New Jersey and at 215-640-7410 for AmeriHealth Pennsylvania.
NaviNet is a registered trademark of NaviNet, Inc.
*Behavioral health providers must submit any changes to their practice information to Magellan via their online Provider Data Change form by selecting the "Display/Edit Practice Info" link.
Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.