NaviNet
What is NaviNet?
NaviNet is an easy-to-use, free, web-based platform that links providers to Keystone First. 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.
Already a NaviNet User?
- Log on to NaviNet Opens a new window.
- Don't see Keystone First Plan Central? Register for Keystone First Opens a new window.
Not a NaviNet user?
- Learn more about this Web-based solution Opens a new window linking providers with health plans.
NaviNet Features & Tools
- NaviNet Provider Data Info (PDIF) User Guide (PDF) Opens a new window
- NaviNet Medical Authorizations Participant Guide (PDF) Opens a new window
- NaviNet Basics Opens a new window
- NaviNet Enhancements Training Guide (PDF) Opens a new window
- NaviNet Medical Authorizations FAQ (PDF) Opens a new window
- Care Gaps
- Condition Optimization Program (COP)
Integrated Care Plan (ICP) Sharing in NaviNet
Claim Inquiry Submission Instructions
Care Gaps
- Provider Guide: Care Gaps Response Form (PDF) Opens a new window
- Care Gap Changes to Align with HEDIS® Measures (PDF) Opens a new window