The AmeriHealth Caritas Ohio Provider Portal, known as NaviNet, is a comprehensive web-based platform designed to streamline communication and administrative processes for healthcare providers. This digital solution offers a quick, efficient way for providers to manage critical healthcare information and interactions.

Official Links

• Provider Portal: https://www.amerihealthcaritasoh.com/provider
• NaviNet Portal: https://www.amerihealthcaritasoh.com/provider/resources/navinet

What is NaviNet?

NaviNet is a no-cost, web-based platform that connects healthcare providers directly with AmeriHealth Caritas Ohio. The portal serves as a centralized hub for essential healthcare management tasks, eliminating the need for traditional paper-based transactions.

What Providers Can Do

Providers 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

Who Can Use It

Healthcare providers affiliated with AmeriHealth Caritas Ohio can use NaviNet. To register, providers will need:

• Office name
• Address
• Phone number
• Tax Identification Number (TIN)

Registration Requirements

During registration, providers must attach one of the following verification documents:

• Certificate of Good Standing
• Sole Proprietor SS-4
• IRS 147C Letter

Access and Login

Providers can register and access NaviNet through the official website. The registration process is designed to be quick and streamlined, with automated identity and business verification.

Features and Services

Key features of NaviNet include:

• Instant access to clinical alerts
• Comprehensive claims management
• Real-time eligibility verification
• Streamlined authorization processes
• Quick information retrieval

Privacy and Security

While specific security details are not extensively outlined in the provided sources, NaviNet emphasizes a secure, digital documentation system for identity verification.

Customer Support

Provider Services Contact:

• Phone: 1-833-644-6001
• Hours: Monday through Friday, 7 a.m. to 8 p.m.
• Closed on major holidays: New Year’s Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving Day, day after Thanksgiving, and Christmas Day

Additional Resources

Providers can access various supporting documents:

• NaviNet Enrollment Guide
• NaviNet Medical Authorizations FAQ
• NaviNet Provider Guide: Care Gaps Response
• NaviNet Claim Investigations Quick Reference Guide

Tutorial videos are also available for:

• Prior Authorization Inquiry Process
• Prior Authorization Submission Process

Billing and Payments

Specific billing and payment portal details were not comprehensively outlined in the provided sources.

Unprovided Information

The following details were not explicitly specified in the source documents:

• Detailed security protocols
• Comprehensive billing portal features
• Specific login procedure steps

NaviNet represents AmeriHealth Caritas Ohio’s commitment to providing healthcare providers with an efficient, user-friendly digital platform. By centralizing critical administrative tasks, the portal aims to enhance communication and streamline healthcare management processes.

Disclaimer: Information is current as of the latest available sources and may be subject to change. Providers should always verify the most up-to-date information directly with AmeriHealth Caritas Ohio.