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Check member ID card and verify eligibility with every visit

January 27, 2020

Some of your AmeriHealth patients may have received a new member ID card for coverage effective in 2020. It is important that providers confirm the member’s coverage and eligibility at each visit, prior to rendering services.

For our AmeriHealth members, providers should:

  1. Make a copy. Obtain a copy of the member’s current ID card to ensure that the most up-to-date information is submitted on the claim.
  2. Verify eligibility and benefits. Verify eligibility and benefits on NaviNet® web portal (NaviNet Open) through the Eligibility and Benefits Inquiry transaction.

There may be occasions when a member’s health insurance goes into effect before receiving a member ID card in the mail. Or, a member may forget the card. If a member does not bring an ID card to an office visit, you have options:

  • You may ask members to print a temporary ID card by logging on to our secure member portal at amerihealth.com.
  • You may access real time, detailed eligibility and benefits information for AmeriHealth members through NaviNet Open using the Eligibility and Benefits Inquiry transaction. There you will find information about a member’s demographics, insurance, and cost-sharing information (i.e., copayment, deductible, and coinsurance).

For your convenience, NaviNet Open and amerihealth.com are available seven days a week.

NaviNet® is a registered trademark of NantHealth.


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