As previously
communicated, provider groups must use the NaviNet? web portal in order to initiate the following authorization types:
- medical/surgical
procedures
- chemotherapy/infusion
- 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, go to NaviNet and select Sign up
from the top right. If your office is currently NaviNet-enabled but 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.