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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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