NaviNet
What is NaviNet?
NaviNet is an easy-to-use, free, web-based platform that links providers to AmeriHealth Caritas Pennsylvania. 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.
Already a NaviNet User?
- Log on to NaviNet
- Don't see AmeriHealth Caritas Pennsylvania Plan Central? Register for AmeriHealth Caritas.
Not a NaviNet user?
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
NaviNet Features & Tools
- Care Gaps
- Care Gap Response Form Provider User Guide (PDF)
- Condition Optimization Program (COP)
- Member Clinical Summary (MCS)
- NaviNet Basics
- NaviNet Care Gap Response Grid (PDF)
- NaviNet Claims Inquiry Enhancement Guide (PDF)
- NaviNet Medical Authorizations FAQ (PDF)
- NaviNet Medical Authorizations Participant Guide (PDF)
- NaviNet Provider Data Info (PDIF) User Guide (PDF)