As of September 15, 2011, we began
enforcing our policy that requires providers to 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
- member responsibility
Providers can view a webinar at www.navinet.net/intro_pss_ah 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 location is not yet registered for
NaviNet, please visit www.navinet.net and
select Sign up from the top right.
If your office is currently NaviNet-enabled but
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 856-638-2701 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.