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Document Exchange coming soon to NaviNet®

June 1, 2016

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As previously communicated, Document Exchange will soon be introduced to providers on the NaviNet web portal. This new feature will allow us to share more information electronically with our provider network.

When Document Exchange is first released, your designated NaviNet Security Officer will control which end users, including himself or herself, associated with your NaviNet office will be given access to the following five unique Practice Document Categories:

  • Billing/Financial Report
  • Patient Roster Report
  • Patient Transition Report
  • Pharmacy Report
  • Program Enrollment Report

Once end users are granted permission to access a specific Practice Document Category, they 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 is important for your 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).

Note: Third-party vendors that have access to NaviNet will not have the ability to access Document Exchange.

Initial report

The High Risk Hospitalization Predictor report from February 2016 will be the first report made available for targeted primary care physician practices under Document Exchange. 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.

For more information

A new user guide for Document Exchange is now available in the NaviNet Resources section of our Provider News Center. It provides detailed instructions on how to use this new feature.

If you have any questions about Document Exchange, call the eBusiness Hotline at 215-640-7410.

Reminder: Provider self-service requirements

All participating providers (including third-party administrators supporting the organization) are required to have access to NaviNet. In addition, all participating providers are required to use NaviNet for specific activities, including:

  • Member Eligibility.The Eligibility and Benefits Inquiry transaction provides you with detailed information relating to our members' eligibility.
  • Claim Status Inquiry. This transaction allows you to view the progress of your accepted claim submission. You can view claims with service dates up to 18 months in the past. The claim detail includes specific information, such as check date, service codes, paid amount, and member responsibility.
  • Claim Investigation. Providers who call Customer Service to question claim payment or to request a claim adjustment must submit those requests through the Claim Investigation transaction. A link to Claim Investigation can be found when searching for a specific claim through Claim Status Inquiry. If, however, you are experiencing an issue that affects a significant number of claims, we recommend that you contact your Network Coordinator for assistance rather than submit an adjustment request through NaviNet.
If you have not yet registered for NaviNet, you can request access by going to the NaviNet website.

NaviNet is a registered trademark of NaviNet, Inc., an independent company.

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This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
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