NaviNet

What is NaviNet?

NaviNet is an easy-to-use, free, web-based platform that links providers to AmeriHealth Caritas Delaware. 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.

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.

Using NaviNet

The following resources will help you use or get started with NaviNet:

• Sign up for NaviNet
• NaviNet Enrollment Guide (PDF)
• Log in to NaviNet
• NaviNet Intensive Case Management Provider Guide (PDF)
• NaviNet Medical Authorization Provider Guide (PDF)
• Identify and improve HEDIS gaps

Jiva

AmeriHealth Caritas Delaware offers our providers access to the Jiva Provider Portal for electronic submission of requests for services, prior authorization and case management activities. The Jiva Provider Portal is accessed through NaviNet using single sign on functionality. Once in NaviNet, our providers may select the Pre-Authorization Management link, and this will launch the Jiva Provider Portal.