NaviNet Updates

This page lists future and past updates to NaviNet health plans and workflows. To filter the list, type a term in the Filter box. 

Release Date Health Plans Workflows Description
03/11/2021 Neighborhood Health Plan of Rhode Island Claim Status Inquiry Starting March 11, you can view additional details about why Neighborhood Health Plan of Rhode Island denied a claim.

Learn more: View additional denial reasons for claims
03/06/2021 Horizon BCBSNJ Claim Status Inquiry Starting March 6, you can attach three additional types of documents to a claim: CPC Audit, Physician Outlier Program, and Vendor Outlier Audit. 

To review all the types of documents that can attach, see What medical attachments can I submit
February/March 2021 All General NaviNet update During February and March 2021, we're rolling out a new sign-in page for NaviNet.

Learn more: NaviNet has a new sign-in page
12/11/2020 Horizon BCBSNJ EFT Registration Starting November 21, 2020, the Horizon EFT transaction has a new name: Horizon EFT/SUA. The transaction is multi-browser compatible.

Learn more: EFT/SUA Registration
10/12/2020 1199SEIU Eligibility & Benefits

Starting October 12, 2020, the 1199 SEIU Eligibility & Benefits Detail screen will display Accumulator Benefit data.

Learn more: View Eligibility & Benefits Accumulator Data

9/25/2020

Horizon BCBSNJ

Horizon NJ Health

Plan-Hosted Transactions

Starting on September 25, Horizon will have a new HealthSphere Registration process. 

Learn more: Register for HealthSphere

9/24/2020

The Health Plan Claim Status Inquiry 

Starting Septemer 24, you can use NaviNet to check the status of a claim for The Health Plan members! You can also attach documents to a claim.

Learn more: Check claim status and attach documents

8/06/2020 Clover Health Claim Status Inquiry

We removed the Servicing Provider drop-down box when you search for a claim.

To remove duplicate entries in the Billing Entity drop-down list, we removed the billing entity address. 

If you still see duplicates when you search for a billing entity, choose any of the matching entries.  

July/August 2020 All General NaviNet update

During July and August 2020, we're rolling out a new look for NaviNet. 

Learn more: NaviNet has a new look!

7/10/2020 Neighborhood Health Plan of Rhode Island Eligibility and Benefits Inquiry

Starting July 10, you can view a member's previous and future coverage details from the Eligibility and Benefits screen.

Learn more: View additional coverage information 

6/12/2020 Geisinger  PCP Panel Inquiry

Starting June 12, you can verify a provider's membership information.

Learn more: PCP Panel Inquiry 

5/15/2020 The Health Plan

Eligibility and Benefits Inquiry

Starting May 15, you can use NaviNet to verify patient eligibility for The Health Plan members!

Learn more: Verify patient eligibility

3/18/2020
  • AmeriHealth
  • Independence Blue Cross
  • Medical Mutual of Ohio
Authorization Submission

You can now save a draft of a new authorization to complete and submit later. 

Learn more: Medical Authorizations 

2/28/2020
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Delaware
  • Highmark Blue Cross Blue Shield West Virginia
  • Highmark Blue Shield
Authorization Submission

The category menu in Authorization Submission for Radiology and Cardiology Authorizations has been streamlined.

Select the new Advanced and Cardiac Imaging category and then select Request as the service option.

The new category replaces CT Scan, CT Angiography, MRI, MRA, PET Scan, and Nuclear Cardiology.

Please refer to Highmark's Plan Central page for additional information.

 

01/31/2020 Neighborhood Health Plan of Rhode Island
  • Eligibility and Benefits Inquiry
  • Claim Status Inquiry

 

There's a new look and feel to your Eligibility and Beneifts Inquiry and Claim Status Inquiry workflows! 

Learn more:

01/14/2020 All General NaviNet update

As part of NantHealth's commitment to provide our users with stable, secure and technologically current applications, the NaviNet Open portal will discontinue support for the Microsoft Windows 7 operating system beginning January 14th, 2020.

This announcement is prompted by Microsoft's plan to end support for this operating system.

NantHealth encourages all users on Windows 7 to move to a supported operating system to minimize any impact to your user experience.

Learn more: End of Support for Windows 7

01/10/2020 Clover Health
  • Claim Status Inquiry
  • Claim Investigation 

Starting January 10, you can use Claim Status Inquiry to check the status of a claim, including viewing an explanation of payment (EOP). 

From Claim Status Inquiry, you can also submit, view, and respond to claim investigations.

Learn more: Claim Status Inquiry and Claim Investigation

12/2019 All General NaviNet Update

Starting December 2019, we will ask you to provide your roles and responsibilities when you sign into NaviNet. Choose the values that best match your roles or responsibilities at your office.

Learn more: Roles and Responsibilities - Frequently Asked Questions

10/29/2019 UPMC Health Plan Eligibility and Benefits Inquiry

We are excited to announce that Eligibility and Benefits Inquiry is now available!

In addition to viewing standard eligibility and benefits information, you can also view a member's Health Reimbursement Account (HRA) balance, depending on the member's plan type.

Learn more: View member eligibility and benefits 

10/28/2019 Horizon NJ Health Claim Status Inquiry

From Claim Status Inquiry, you can now investigate a claim online. This feature reduces phone calls to the health plan about claims, and provides a history of all investigations for any user in the office. 

Learn more: Investigate a claim online

10/7/2019
  • AmeriHealth 
  • AmeriHealth Caritas Louisiana
  • Blue Cross and Blue Shield of Nebraska
  • Health Partners Plans
  • Independence Blue Cross
  • Patient Clinical Documents Documents
  • Practice Documents

You can now use the new Provider Filter when searching for patient and practice documents. You no longer need to perform attestation.

For more information, see the Provider Filter user guide, or watch a quick video.

09/16/2019 Health Partners Plans Patient Clinical Documents You can now exchange clinical information regarding your patients electronically via the Chronic Care Management Program (CCMP). Please see the New Feature Guide for additional information. 
08/17/2019
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Delaware
  • Highmark Blue Cross Blue Shield West Virginia
  • Highmark Blue Shield
  • Auth Inquiry and Reports
  • Authorization Submission
  • Behavioral Health Authorization Submission
  • Facility Authorization Submission
  • Home Care/Hospice
  • Request for More INformation Action Items

You can now attach supporting documentation electronically to your Highmark authorizations. This feature will eliminate the need for you to fax supporting documents separately or to wait for assistance by phone when contacting Highmark. 

Please view the New Feature Guide for additional information on adding attachments. Also remember to view the updates that Highmark has posted on their NaviNet Plan Central page and the Resource Center.

08/05/2019 Aetna Claim Status Inquiry You can now view claim attachment history.  To view the attachment history for a claim, click History in the upper-right corner of the Claim Status Details screen. 
07/22/2019 Horizon BCBSNJ Claim Status Inquiry

There's a new look and feel to your Claim Status Inquiry workflow. To submit appeals, click Attach in the top-right corner of the screen.

Learn more: Enhanced Claim Status Workflow

06/03/2019 Highmark Blue Cross Blue Shield Delaware Claim Investigation

Submit claim investigations for Health Options Delaware members directly from the Claim Status Inquiry transaction. You no longer need to access the Enhanced Provider Features transaction for claim investigations. 

View the status of your investigations using the Claim Investigation Inquiry transaction. 

Learn more: Claim Investigation User Guide

06/03/2019 West Virginia Family Health Claim Investigation

Submit claim investigations directly from the Claim Status Inquiry transaction. You no longer need to access the Enhanced Provider Features transaction for claim investigations.

View the status of your investigations using the Claim Investigation Inquiry transaction. 

Learn more: Claim Investigation User Guide

06/01/2019 All General NaviNet Update

Starting June 2019, we will start asking you to provide and verify your email address.

Learn more: Email Address - Frequently Asked Questions

06/01/2019 Medical Mutual of Ohio Authorizations

Beginning June 1, 2019, Medical Mutual will require that all prior authorizations for medical services be submitted through NaviNet. The exceptions are for medical drug, radiology, chiropractic services, as well as physical, occupational and speech therapies. Medical Mutual will no longer accept authorizations by fax or phone.

 

Please note that in-patient Hospital/SNF/Rehab/LTAC prior authorization requests are excluded from this requirement and must continue to be submitted to Medical Mutual through ReviewLink, phone, and fax.

 

To learn more, review the Authorization Inquiry & Submission and Authorization log guides, or watch a quick video

05/24/2019
  • AmeriHealth
  • Independence Blue Cross
  • Medical Mutual of Ohio
  • QualCare 
Medical Authorizations Log

You no longer need to attest to billing entities when accessing the Medical Authorizations Log. You can now view authorization records that are associated with any billing entity included in your office.

Use the new Billing Entitites filter to help choose the billing entities whose authorization records you prefer to see. Save your preferred list of billing entities for future use. To learn more, see the Billing Entities Filter user guide. 

04/27/2019 All General NaviNet Update

On Saturday, April 27, NaviNet will perform maintenance on our Customer Support tool. Customer Support personnel will be available by phone to assist you during regularly scheduled hours, 8 a.m. through 3 p.m. EST. 

During this maintenance window, you won't be able to open a case online or use our chat feature. 

Thank you for your patience while we make improvements to serve you better.

04/24/2019 Aetna Claim Status Inquiry - Attachments When you attach a document to a claim, the document type is selected by default so you don't have to select it. 
04/24/2019
  • AmeriHealth Caritas Delaware
  • AmeriHealth Caritas District of Columbia (ACDC)
  • AmeriHealth Caritas Louisiana
  • AmeriHealth Caritas PA Community Health Choices
  • AmeriHealth Caritas Pennsylvania
  • Blue Cross Complete of Michigan
  • Capital BlueCross
  • Keystone First
  • Keystone First Community Health Choices
  • PerformCare
  • Select Health of South Carolina    
Claim Investigation

This release includes the following features:

  • When you view a claim in Claims Log or Claim Status Inquiry, you can now click History to view all claim investigations that users submitted through NaviNet. Click an investigation to view its details.
  • On the Claim Status Details screen, a red badge appears on the Investigate link if the health plan responded to an investigation on the claim and you or another user have not yet viewed it. After any user views the response, the badge no longer appears.
  • All Claim Status users can now view investigations on a claim. Previously, only users with Claim Investigation permissions could view investigations.

    To start new investigations or reply to existing ones, however, your Security Officer must give you access. Contact your Security Officer if you have questions.

 

04/13/2019
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Delaware
  • Highmark Blue Cross Blue Shield West Virginia
  • Highmark Blue Shield  
Eligibility and Benefits Inquiry

View a patient's pharmacy benefits by clicking the new Pharmacy Product Wide Provisions link on the Eligibility and Benefits Details page.

For a screenshot of the link, see View pharmacy benefits.

02/22/2019
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Delaware
  • Highmark Blue Cross Blue Shield West Virginia
  • Highmark Blue Shield   
Authorizations

Highmark will be offline 9 p.m. Friday, February 22 through 12 p.m Saturday, February 23 for scheduled maintenance. 

To avoid unnecessary faxing during this time, please hold any authorization requests until NaviNet is available after 12 p.m. on February 23.

 

Please note: The maintenance activities will purge all Incomplete authorizations from the Referral/Authorization Log.

02/06/2019
  • AmeriHealth Caritas Delaware
  • AmeriHealth Caritas District of Columbia (ACDC)
  • AmeriHealth Caritas Louisiana
  • AmeriHealth Caritas PA Community Health Choices
  • AmeriHealth Caritas Pennsylvania
  • Blue Cross Complete of Michigan
  • Capital BlueCross
  • Keystone First
  • Keystone First Community Health Choices
  • PerformCare
  • Select Health of South Carolina 

Claim Investigation

Save your contact information so you don't have to re-enter it every time you start a claims investigation.

To save your contact information, select the Save as default contact information check box in the Start Investigation pane.

02/06/2019

  • Aetna
  • Allina Health Aetna
  • Banner Aetna
  • Horizon BCBSNJ
  • Innovation Health
  • Sutter Health Aetna
  • Texas Health Aetna
Claim Status Inquiry - Attachments

View the history of all documents that users attached to a claim. You can view the actual document as well as who attached it and when.

To view the history, click History above the claim status bar.

12/14/2018
  • Aetna
  • Allina Health Aetna
  • Banner Aetna
  • Innovation Health
  • Sutter Health Aetna
  • Texas Health Aetna
Precertification Inquiry

Amend or cancel a precertication that you previously submitted. 

Learn more: Amend or cancel a precertification

12/03/2018

 

Horizon BCBSNJ Referrals and Authorizations

Submit preauthorization requests that comply with the Surgical and Implantable Device Management Program.

Learn more: Submit Surgical and Implantable Device Management Program preauthorization requests using TurningPoint

11/27/2018 Horizon BCBSNJ Claim Status Inquiry

There's a new look and feel to your Claim Status Inquiry workflow. To submit appeals, click Attach in the top-right corner of the screen.

Learn more: Enhanced Claim Status Workflow

10/18/2018
  • Aetna
  • Allina Health Aetna
  • Banner Aetna
  • Innovation Health
  • Sutter Health Aetna
  • Texas Health Aetna
Claim Status Inquiry

Attach documents to pended claims.

Learn more: Attach documents to a claim

09/28/2018
  • Aetna
  • Allina Health Aetna
  • Banner Aetna
  • Innovation Health
  • Sutter Health Aetna
  • Texas Health Aetna
  • Eligibility and Benefits Inquiry
  • Claim Status Inquiry
  • Referral Submission and Inquiry
  • Precertification Submission and Inquiry
  • Payment Estimator

When you use first name to search for a patient, you must now type the patient's entire first name. This feature helps you find the right patient. 

08/24/2018 Horizon BCBSNJ Physical and Occupational Therapy (PT/OT) Authorization

This release removes the PT/OT Authorization workflow.

You now click Referrals and Authorization > Utilization Management Requests to submit PT/OT authorization requests.

Learn more: What is the Utilization Management Request Tool