NaviNet
What is NaviNet?
NaviNet is an easy-to-use, no-cost, web-based platform that links providers to AmeriHealth Caritas Ohio. Through NaviNet, you can access and submit:
-
Real-time clinical Healthcare Effectiveness Data and Information Set (HEDIS) alerts
- Eligibility information
- Claims information and updates
- Benefits information
- Drug authorizations
- Prior authorizations
NaviNet helps speed up the provider-health plan connection and can often replace paper transactions. If you're not a NaviNet user, learn more about how to sign up for NaviNet.
Register for NaviNet
NaviNet provides a quick and streamlined registration process using our digital documentation system for automated identity and business verification. When registering for NaviNet, please have the following information ready to be entered into the online registration form:
- Office name
- Address
- Phone number
- TIN
You will also be asked to attach one of the following documents for verification:
- Certificate of Good Standing
- Sole Proprietor SS-4
- IRS 147C Letter
Using NaviNet
The following resources will help you use or get started with NaviNet:
- Sign up for NaviNet
- Log in to NaviNet
- NaviNet Enrollment Guide (PDF)
- NaviNet Medical Authorizations Training Guide (PDF)
- NaviNet Medical Authorizations Frequently Asked Questions (FAQ) (PDF)
- NaviNet Provider Guide: Care Gaps Response (PDF)
- NaviNet Claim Investigations Quick Reference Guide (PDF)
- Tutorial Video — Prior Authorization Inquiry Process
- Tutorial Video — Prior Authorization Submission Process