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As previously communicated, beginning September 27, 2013, you will begin to
see the changes to the NaviNet web portal that will affect
the way you do business with IBC. These changes are being made as IBC
transitions to a new operating platform, which
will offer greater capabilities, increased flexibility in benefit design, and
enhanced functionalities for an improved overall
customer experience.
To help you better understand these changes, we will make available new user
guides by mid-September that will
describe the following NaviNet transactions in detail:
- Claim Status Inquiry (including Claims INVESTIGATION)
- BlueExchange? Out of Area (Eligibility and Benefits Inquiry,
Claim Status Inquiry)
- Eligibility and Benefits Inquiry
- Encounter Submission
Given the significant number of changes to be implemented, we urge
you to review these new user guides prior
to September 27. They will be available in the NaviNet Transaction
Changes section of our Business Transformation
website. Announcements will be made on NaviNet Plan Central and on our
Provider News Center once the new guides
are posted. Please check these sites frequently
for updates.
Self-service webinars will also be made available in September. An
announcement will be made on IBC NaviNet Plan
Central when they are available.
Reminder: Interruption for some transaction functionality
As we continue our work with transitioning to the new platform, some
functionality will be disabled or temporarily
suspended starting September 27, 2013, including the following:
- Clear Claim ConnectionTM. This transaction is a
web-based reference tool designed to evaluate code
combinations during the auditing of professional claims. By accessing the tool,
the user can view the justifications
and clinical rationale on how a professional claim processes. On September 27,
2013, this NaviNet transaction will be
disabled. It will be released again in April 2014. However, this tool will
remain available to all providers in the Clear Claim ConnectionTM section of our website.
- Clinical Alerts and Clinical Care Reports. Clinical Alerts
and Clinical Care Reports will be temporarily disabled
starting September 27, 2013. The Clinical Alerts feature is a clinical practice
tool that alerts providers when their
patients have not received a recommended service. Currently, Clinical Alerts
are available to primary care physicians,
cardiologists, OB/GYNs, and endocrinologists. Beginning in December, access to
Clinical Alerts will be re-established
and will be expanded to all provider specialties.
- Fee Schedule Inquiry. This transaction will be temporarily
disabled starting September 27, 2013, and it is scheduled
to be re-introduced in the first quarter of 2014. Until this transaction
becomes available again next year, please contact
your Network Coordinator for fee schedule inquiries.
- Provider Change Form. This transaction will be temporarily
disabled starting September 27, 2013. Until it becomes available again,
professional
providers should complete a Provider
Change Form or contact their Network
Coordinator to make any provider record changes.
For the most up-to-date information about our transition to a new claims
processing platform, we encourage you to frequently visit our Business
Transformation website.
If you have any questions regarding upcoming NaviNet transition changes please
call the Business hotline at 215-640-7410.
NaviNet® is a registered trademark of
NaviNet, Inc., an independent company.
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