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Changes coming in mid-September to NaviNet®

September 1, 2015

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The following new transactions and enhancements will be introduced on the NaviNet web portal in mid-September:

  • Eligibility and Benefits Inquiry. A new Eligibility and Benefits Inquiry transaction will be introduced in a phased approach. In mid-September, the member search criteria will be modified, and the presentation of the Eligibility and Benefits Detail screen will change. The Details screen will continue to include links to the member's capitated site information (where applicable), the member's ID card, and product-wide provisions associated with the member's benefits plan; however, other benefit links will not be available.
  • Provider File Management. This new transaction replaces the previously retired Provider Change Form transaction. Provider File Management will allow professional providers to:
    -- modify practice information
    -- add hospital affiliations
    -- add participating providers
  • ICD-10. To support the October 1, 2015, compliance deadline for ICD-10, portal transactions that reference or leverage diagnosis codes will be updated. When submitting referrals, encounters, and authorization requests or when searching for a diagnosis on NaviNet for dates of service or dates of discharge (for facility inpatient claims) on or after October 1, 2015, providers must use ICD-10 codes.
  • COB Questionnaire. A new transaction will be introduced with a new Coordination of Benefits (COB) Questionnaire. This electronic form will allow providers to report and submit Other Party Liability coverage for members. Reporting COB information at the time of service will help claims process correctly.
More information about these new and updated transactions will be communicated in the coming weeks and through future editions of Partners in Health UpdateSM. In addition, we will also publish new user guides in the NaviNet Resources section of our Provider News Center to help you better navigate the listed transactions. Announcements will be made on Independence NaviNet Plan Central and on our Provider News Center once the new guides are available.

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

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

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