As previously communicated, beginning September 27, 2013, you will begin to see changes to the NaviNet web portal that will affect the way you do business with AmeriHealth.

To help you better understand these changes, we will make available new user guides by mid-September that will describe the following NaviNet transactions in detail:

• Claim Status Inquiry (including Claims INVESTIGATION)
• Eligibility and Benefits Inquiry
• Encounter Submission

Given the significant number of changes to be implemented, we urge you to review these new user guides prior to September 27. They will be available in the NaviNet Transaction Changes section of our Upcoming System and Process Changes website. Announcements will be made on NaviNet Plan Central and on our Provider News Center once the new guides are posted. Please check these sites frequently for updates.

Self-service webinars will also be made available in September. An announcement will be made on AmeriHealth NaviNet Plan Central when they are available.

Reminder: Interruption for some transaction functionality

As we continue our work to transition AmeriHealth Pennsylvania members to a new claims processing platform, some functionality will be disabled or temporarily suspended starting September 27, 2013, including the following:

• Clear Claim Connection^TM. This transaction is a web-based reference tool designed to evaluate code combinations during the auditing of professional claims. By accessing the tool, the user can view the justifications and clinical rationale on how a professional claim processes. On September 27, 2013, this NaviNet transaction will be disabled. It will be released again in April 2014. However, this tool will remain available to all providers in the Clear Claim Connection^TM section of our website.
• Clinical Alerts and Clinical Care Reports. Clinical Alerts and Clinical Care Reports will be temporarily disabled starting September 27, 2013. The Clinical Alerts feature is a clinical practice tool that alerts providers when their patients have not received a recommended service. Currently, Clinical Alerts are available to primary care physicians, cardiologists, OB/GYNs, and endocrinologists. Beginning in December, access to Clinical Alerts will be re-established and will be expanded to all provider specialties.
• Fee Schedule Inquiry. This transaction will be temporarily disabled starting September 27, 2013, and it is scheduled to be re-introduced in the first quarter of 2014. Until this transaction becomes available again next year, please contact your Network Coordinator or Hospital/Ancillary Services Coordinator for fee schedule inquiries.
• Provider Change Form. This transaction will be temporarily disabled starting September 27, 2013. Until it becomes available again, professional providers should complete a Provider Change Form or contact their Network Coordinator to make any provider record changes.

For the most up-to-date information about upcoming changes, we encourage you to frequently visit our Upcoming System & Process Changes website. If you have any questions regarding upcoming NaviNet transaction changes, please call the eBusiness hotline at 215-640-7410 for Pennsylvania and Delaware providers or at 609-662-2565 for New Jersey providers.

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