As previously communicated, providers
must use the NaviNet? web portal in order to
initiate the following authorization types:
- medical/surgical procedures
- chemotherapy/infusion therapy
- 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
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,
you must do so by April 1, 2013. To register, please visit NaviNet and select Sign Up from the
top right. If your office is currently NaviNet-enabled and would like training
on how to submit authorizations, please call the eBusiness Provider Hotline at
215-640-7410.
Note: This information does not apply to
providers contracted with Magellan Behavioral Health, Inc. Magellan-contracted
providers should contact their Magellan Network Coordinator at 1-800-866-4108 for authorizations.
Magellan Behavioral Health, Inc., an independent
company, manages mental health and substance abuse benefits for most IBC
members.
NaviNet® is a registered trademark
of NaviNet, Inc., an independent company.