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NaviNet Open Resources

To help you navigate our secure, online provider portal and various transactions, we have created a central location for a variety of NaviNet Open resources, including user guides, webinars, and a communications archive.

NaviNet Open

Pre-service Review for
Out-of-area Members

NaviNet Open users no longer have to call the out-of-area member’s health plan to request preapproval.

Learn more

NaviNet® Open Registered Users

Independence Blue Cross provides a variety of resources and information to ensure that you and your staff are comfortable with NaviNet web portal (NaviNet Open).

User Guides

Independence and NaviNet Open have worked together to create a variety of helpful user guides that provide easy step-by-step instructions for completing tasks and transactions via NaviNet Open).

Visit the NaviNet Open section of our Provider News Center and download a variety of user guides covering such topics as eligibility and benefits, referral submissions, EOB and remittance inquiries, claim status inquiries, and more.

Training

Participating provider offices can contact Independence for training. We provide NaviNet Open training over the phone and on-site for larger groups.

Provider Network Services Hotline:

  • PA & DE providers: 215-640-7410
  • NJ providers: 609-662-2565

Provider Self-service Requirements

Independence-participating providers must use NaviNet Open or the Provider Automated System to obtain certain information. These requirements pertain to participating providers, facilities, Magellan-contracted providers, and billing agencies that support provider organizations.

This document details the self-service requirements for which providers must use NaviNet Open.

PDF iconProvider Self-service Requirements

Eligibility and claims status

All participating providers and facilities are required to use NaviNet Open (or call the Provider Automated System) to verify member eligibility and check Independence claims status information. The claim detail provided through either system includes specific information, such as check date, check number, service codes, paid amount, and member responsibility.

Claim adjustments

Participating providers who call Customer Service to question a claim payment or to request a claim adjustment will be directed to submit the request via NaviNet Open using the Claim Investigation transaction.

Authorizations*

All participating providers and facilities must use NaviNet Open in order to initiate the following authorization types: medical/surgical procedures, chemotherapy/infusion therapy, 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.

*This information does not apply to providers contracted with Magellan Behavioral Health, Inc. (Magellan). Magellan-contracted providers should contact their Magellan Network Coordinator at 1-800-866-4108 for authorizations.

If you have questions regarding these requirements, please contact our eBusiness Provider Hotline at 215-640-7410.

NaviNet® is a registered trademark of NantHealth, an independent company.

The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.