As a reminder, the Provider File Management transaction on the NaviNet web portal allows professional providers to view and submit specific updates to their Independence provider record.
Note: The Provider File Management transaction is not intended for use by facilities, skilled nursing facilities, ancillary providers, or providers contracted with Magellan Healthcare, Inc. (Magellan)*, an independent company.
Professional providers can initiate the following updates as it relates to their practice:
- Add/Delete a participating practitioner to/from an existing practice
- Add/Delete an address (i.e., doing business as [DBA], check, mailing, main, or practice)
- Add/Delete contact name, title, or communication device type/number
- Add/Delete office hours
- Update ?Walk-in? acceptance status
- Update Patient and Appointment Options (i.e., accepting new patients)
- Update General Practice Availability (i.e., Urgent, Routine Visits, etc.)
- Update Member Access number (i.e., the telephone number that appears on the member?s identification card ? which must be the location-specific telephone number for a patient to make an appointment)
- Update Electronic Medical Records (EMR) status
- Update the availability of other clinical staff (i.e., midwife, nurse practitioner, etc.)
- Update office accessibility and services (i.e., handicapped, parking, and communication and language services)
Additional tips to help you update your practice information:
- All practice addresses should be located within the same state.
- Providers that participate in a delegated arrangement must be credentialed by Independence before joining a non-delegated practice.
- It is important that the credentialing status of the practitioner is verified with Independence prior to adding a physician to a practice. If a practitioner who is not participating with Independence is added to a practice, consequences including claim denials, inaccurate reimbursement, and immediate removal from the provider directories may be imposed.
- Closed Networks. There are limitations to participation for the Pathology, Podiatry, and Chiropractic Networks. For additional information, please review the Closed Networks section of our Professional Provider Credentialing webpage.
Important information on updating your provider record
Providers are strongly encouraged to use the Provider File Management transaction to update provider records. If Independence receives provider record updates that can be submitted using the Provider File Management transaction, a member of our eBusiness team may reach out to that provider to assist them in using the transaction to make the necessary updates. This will allow our team to receive user feedback on the transaction and help improve the overall user experience for our network.
More information
A Provider File Management Guide is available to assist you in navigating this transaction and ensure accurate submissions. The guide is available in the NaviNet Resources section. If you have any further questions on this transaction, please contact the eBusiness Hotline at 215-640-7410.
*Behavioral health providers must submit any changes to their practice information to Magellan via their online Provider Data Change form by selecting the ?Display/Edit Practice Info? link.
NaviNet is a registered trademark of NaviNet, Inc., an independent company.
Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most Independence members.