Beginning July 20, 2016, for a number of provider
offices, we will introduce a new Eligibility and Benefits
Inquiry transaction in the AmeriHealth Workflows menu
on the NaviNet® web portal. All remaining NaviNet-enabled
participating providers will be given access
to the new transaction starting August 3, 2016. The
member search criteria in the updated transaction will be
modified, and the presentation of eligibility and benefits
information will change.
The Eligibility and Benefits Inquiry transaction will
continue to provide access to detailed, real-time eligibility
and benefits information for AmeriHealth members, as
well as information about a member?s demographics,
insurance, and cost-sharing (e.g., copayment,
coinsurance, deductible). The Eligibility and Benefits
Details screen will offer a list of benefit categories to
view and will continue to include links to information
about the member?s capitated sites (where applicable),
member ID card, and product-wide provisions associated
with the member?s benefit plan.
The new Eligibility and Benefits Inquiry transaction
will allow you to search for a member?s eligibility and
benefits record for up to two years preceding the
current date. However, when the new transaction is first
released, you will only be able to retroactively search for
dates of service on or after October 1, 2015. Eligibility and
benefits information for AmeriHealth members will not
be available through NaviNet for dates of service prior to
October 1, 2015.
In the coming weeks, we will publish a new user guide
for the updated Eligibility and Benefits Inquiry transaction
in the NaviNet Resources section of our Provider
News Center.
Once available, we will make an announcement on
the Provider News Center as well as on AmeriHealth
NaviNet Plan Central.
If you have any questions about the upcoming changes
to the Eligibility and Benefits Inquiry transaction, call
the eBusiness Hotline at
609-662-2565 for AmeriHealth
New Jersey or at 215-640-7410 for AmeriHealth
Pennsylvania.
New Document Exchange feature postponed
The release of the new Document Exchange feature has been postponed until
later in the third quarter of 2016.
As a reminder, this new feature will allow AmeriHealth to share information
electronically with our provider
network. Your NaviNet Security Officer will control which end users, including
himself or herself, associated
with your NaviNet office will be given access to five unique Practice Document
Categories.
Note: Third-party vendors with access to NaviNet will not have the
ability to access Document Exchange.
A user guide for Document Exchange is available in the NaviNet Resources section of our Provider
News Center.
Look for additional information about Document Exchange in future editions
of Partners in Health UpdateSM.
NaviNet is a registered trademark of NaviNet, Inc.