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. If you're not a NaviNet user, learn more about NaviNet.

Already a NaviNet User?

• Log on to NaviNet
• Don't see AmeriHealth Caritas Pennsylvania Plan Central? Register for AmeriHealth Caritas.

Not a NaviNet user?

• Learn more about this Web-based solution linking providers with health plans.

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)

Integrated Care Plan (ICP) Sharing in NaviNet

• ICP NaviNet Assessment Instructions (PDF)