As previously communicated in
Partners in Health UpdateSM, all provider groups were to have
all site locations NaviNet-enabled by January 1, 2011, in order to initiate the
following authorization types through the NaviNet? web portal:
- medical/surgical
procedures
- cardiac rehabilitation*
- chemotherapy/infusion
- durable medical equipment
- emergency hospital admission
notification
- home health
- dietitian
- home health aide
- occupational therapy
- physical therapy
- skilled nursing
- social work
- speech therapy
- home infusion
- outpatient speech therapy
- pulmonary rehabilitation*
- sleep studies*
Please note that the representatives at
the Health Resource Center are no longer able to initiate the authorizations
listed above.
Tips for submitting
authorizations
NaviNet submissions that result in a
pended status can take up to two business days to be completed. These may
include requests for additional clinical information as well as requests that
may result in a duplication of services. If the authorization remains pended
beyond two business days, or if the authorization request is urgent, providers
should call 1-800-ASK-BLUE for assistance.
Requests for medical/surgical
procedures can be made up to six months in advance on NaviNet, and in most
cases, requests for medically necessary care are authorized immediately.
In some instances, providers can modify
the date of service previously approved by selecting Authorizations from
the Plan Transactions menu and then Authorization Status
Inquiry.
About NaviNet
For your convenience, NaviNet is available to all
participating providers Monday through Saturday, 5 a.m. to 10 p.m., and Sunday,
9 a.m. to 9 p.m. If your office location has not yet registered for NaviNet, go
to www.navinet.net and select Sign up from
the top right. If your office is currently NaviNet-enabled but would like
training on how to submit authorizations, please call the eBusiness Provider
Hotline at 215-640-7410.