NaviNet® provider portal
AmeriHealth New Jersey offers network providers a way to simplify health care administration through our NaviNet web portal. Get fast, secure, HIPAA-compliant access to provider and member information and make real-time transactions. It's free and requires no additional software.
Information at your fingertips
- Eligibility and benefits
Determine a patient's plan type, his or her primary care physician (HMO only), capitated sites (when applicable), coverage dates, copayments, etc.
- Claims data
Retrieve up to two years of historic claims data (including paid, denied and in-process/pended claims).
- Clinical alerts
Receive patient-specific preventive care reminders for due, or past due, services (available to PCPs, OB/GYNs, endocrinologists and cardiologists).
- Clinical care reports
Get a quick snapshot of the care that patients have received based on AmeriHealth-paid medical and prescription drug claims (available to professional and facility providers only).
- Authorization status
Review the status of inpatient, outpatient and concurrent reviews.
Retrieve electronic referrals (within 365 days of the referral date).
- Statement of remittance
Don't wait to receive paper-review your SORs online.
- Service accumulators
Determine if a member has exhausted a particular benefit during the benefit year.
- Capitation rosters
Access up-to-date rosters of your assigned HMO members.
- Code inquiries
Perform code-to-English/English-to-code procedure and diagnosis code inquiries.
Submit information quickly through NaviNet
- Authorization requests
- Adjustments to claims
- Electronic payments
- Report covered services performed by PCPs that are part of the PCP capitation arrangement with the plan (for use by PCPs only)
- Practice changes
- Drug prior authorization requests
- Emergency admission notifications (for use by hospitals only).
Requirements for NaviNet portal registration:
You must be an AmeriHealth-participating provider.
Technical requirements include:
- Windows 7 (or more recent) Microsoft operating system;
- Internet connection (high-speed recommended; minimum 56k dial-up speed);
- Internet Explorer 11 web browser on Windows 7, Mozilla Firefox (latest version), or Google Chrome (latest version).
Get NaviNet for your office. Just complete the online registration request form to register.
For questions regarding NaviNet, contact their Customer Care at 888-482-8057.
Participating provider offices can contact AmeriHealth New Jersey for training. NaviNet portal training is available over the phone or on-site for larger groups. Call 609-662-2565 to schedule a NaviNet training session.
NaviNet® is a registered trademark of NaviNet, Inc.