We will be introducing the new Claims Dashboard transaction on the NaviNet web portal in May and another new NaviNet feature, Document Exchange, in June.
Claims Dashboard
The release of Claims Dashboard was postponed until May. This new transaction will offer you a comprehensive dashboard of all pended and finalized claims. Providers will be able to view their accounts receivable for claims in a pended or finalized status. Your designated NaviNet Security Officer will automatically be granted access to Claims Dashboard, and he or she can enable the transaction for others in your office.
A user guide for Claims Dashboard will be made available prior to the release of this new transaction. Announcements will be made on Independence NaviNet Plan Central and on our Provider News Center once the new guide is available.
Note: Claims Dashboard does not provide detail for individual claims. Please continue to use the Claim Status Inquiry transaction to obtain specific claim detail.
Document Exchange
Document Exchange is a new feature that will be introduced to providers in June and will allow us to share more information electronically with you through NaviNet.
Your designated NaviNet Security Officer will have access to the transaction when it is first released. He or she will control access to five unique Practice Document Categories for authorized end users associated with your NaviNet office.
Practice Document Categories include the following:
- Billing/Financial Report
- Patient Roster Report
- Patient Transition Report
- Pharmacy Report
- Program Enrollment Report
Once an end user is granted permission to access a specific Practice Document Category, that individual will be able to view and download any documents associated with that category. For example, if a NaviNet Security Officer grants permission to an associate to access the Billing/Financial Reports category, all reports made available by Independence under that category will be available to the associate to view or download.
It will be important for your designated NaviNet Security Officer to manage permissions appropriately for each document category to ensure reports are accessed in a manner that is compliant with role-based access requirements of the Health Insurance Portability and Accountability Act (HIPAA).
A user guide for Document Exchange will be made available prior to the release of this new feature. Announcements will be made on Independence NaviNet Plan Central and on our Provider News Center once the new guide is available.
Initial report
The first report that will be made available under Document Exchange will be the High Risk Hospitalization Predictor report from February 2016, which will be made available to targeted primary care physician practices. Based on a predictive model, this report identifies members you have treated who are at high risk of acute hospitalization in the next six months and who have one or more of the following chronic conditions:
- chronic obstructive pulmonary disease (COPD)
- congestive heart failure (CHF)
- coronary artery disease (CAD)
- diabetes
If you have questions or suggestions that relate to the High Risk Hospitalization Predictor report, please contact your network medical director.
If you have any questions about either of these NaviNet features, please call the eBusiness Hotline at 215-640-7410.
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