How do I know what my claim denied is inclusive to? (Feb. 15, 2024)
When looking at the claim in NaviNet, the detail is provided just above the claim-level information. It could be for another claim or another procedural code.
Why is there not a claim number on my duplicate denial? (Feb. 15, 2024)
Non-Nebraska members claim denials are determined by the member’s plan and will not display in NaviNet.
Will the denial messages in NaviNet be on the remit or on my 835s? (Feb. 15, 2024)
The enhanced denial messages are exclusively available in NaviNet.
What claims will I be able to view enhanced denial messages for in NaviNet? (Feb. 15, 2024)
This will apply to claim denials for claim types: Professional, Institutional and Dental.
What date did the claim denial enhancement take effect? (Feb. 15, 2024)
Enhanced messaging on claim denial reasons was added Dec. 29, 2023.
I have reviewed the denial detail in NaviNet but I still have questions. What should I do now? (Feb. 15, 2024)
Please refer to your coder/biller for additional review prior to sending a claim investigation.
Registering for NaviNet
Who can access NaviNet?
Participating health care and dental providers, and non-participating health care providers within the state of Nebraska who have their information on file with BCBSNE can enroll for access to Navinet.
Is there a cost to access NaviNet?
No, there is no cost to access NaviNet. BCBSNE offers the NaviNet features and functionality at no charge.
How do I register with NaviNet?
Each office must have a minimum of one Security Officer who is responsible for registering with NaviNet, adding users to the account, and granting user access. Your designated security officer should go to https://register.navinet.net to begin the registration process.
- Registration takes between five to seven business days.
- Registration requires a Tax ID and email address.
- Each user will have their own username and password. No sharing is allowed.
- Users have 60 days to log in for the first time before they will become disabled.
- Users should see their Security Officer to have their password reset if they become disabled.
- See the Provider Registration Flyer for more information.
How can I check the status of my registration?
You may check the status of your NaviNet registration at any time from the Registration Page or Help Center.
I am already registered with NaviNet. Do I have access to BCBSNE information?
If you are an existing NaviNet user, and are either a participating BCBSNE network provider, or are a healthcare provider within the state of Nebraska, you should see Blue Cross and Blue Shield of Nebraska as an option in your Health Plans List.
Our office outsources our billing and payment to a third-party billing service. Can a billing service register with NaviNet?
Yes, a third-party billing service can register with NaviNet, but for security, the registration process will include validation and authentication with the provider office before access is permitted. You can contact your Security Officer for help in adding new users or you can provide the billing service with this link to register as a third party with NaviNet.
What do I do if I am unable to complete NaviNet Registration?
Please verify that the phone number and address you entered when registering for NaviNet matches the phone number and address you have on file with BCBSNE.
If this information is valid and you are still unable to register, please email ProviderExecs@NebraskaBlue.com.
Who should I contact if I experience any difficulties using NaviNet?
To report a technical problem, contact the NaviNet help desk at 888-482-8057 – available Monday - Friday, 7:00 a.m. – 10:00 p.m. CT, Saturday, 7:00 a.m. – 2:00 p.m. CT.
Accessing Fee Schedules
Are you a PHO Provider?
For PHO providers, please contact your PHO representative directly.
Are you a newly credentialed provider?
For newly credentialed providers without access to NaviNet, you will receive information on how to register with your BCBSNE acceptance letter. You may also watch the eLearning videos found in the Provider Academy.
Are you registered with NaviNet?
If you are not registered for NaviNet please see our Provider Academypage.
For all other providers please follow the step-by-step instructions below
For providers who do not belong to a PHO and are not a newly credentialed provider, please follow the steps below. Please note: The Provider Executive Team does not send fee schedules. To access fee schedules, please log in to NaviNet®.
Your system administrator will need to give you access to Practice Documents. If they have any questions on how to do this, they will need to call NaviNet directly at 1-888-482-8057. If they already have, when you log in, under workflow you will need to click Practice Documents.
Your next steps will be to attest.
Once you attest you should be able to bring up the fee schedule. If you still cannot view your fee schedule, your system admin/security officer will need to change/update the user permission. It will state Security Office-User Permission and edit access and enable practice documents. If your system admin (or if you are the system admin) need assistance on this, please contact NaviNet directly at 1-888-482-8057.
NaviNet on new Windows 10 for Internet Explorer (or they can skip these steps and use Google Chrome):
- Go to the NaviNet login page.
- Prior to logging in, click the blue stop indicator in the URL line, between the lock and refresh.
- You’ll get a pop up, click “Turn off ActiveX Filtering”.
- This turns off the ActiveX Filtering for all downstream sites connected to the NaviNet login page. You’re all set!
Am I required to use NaviNet as a third-Party vendor?
Yes, all in-network providers, as well as the vendors supporting them, are required to use NaviNet for claims, benefits, and other questions.
Check Claims Status Help Guide
Help Guide
Where can I see specific claim denial information in NaviNet?
After performing a Claim Status Search, specific denial reasons will be shown for each denied claim line in Claim Status Details. Denial messages corresponding to the claim line number will be displayed directly above the Claim and Service Line Details.
How can I check on the status of my NaviNet registration?
You may check the status of your NaviNet registration at any time from the Registration Page or Help Center.
How long does it take to get access to NaviNet?
If a provider’s registration information is accurate, complete, and matches the information we have on file, the NaviNet registration process should take five to seven business days. If anything does not match, NaviNet will attempt to reach the provider by phone for clarification.
Upon initial enrollment, you will get an acknowledgment email from enrollment@navinet.net. Once confirmed, you will get another email with login information and next steps.
What if I work as a vendor for a provider office and/or facility?
Visit the NantHealth Help Center to register as a third party with NaviNet and follow the steps on the page.
Who do I contact if I have issues with NaviNet?
If there are questions or concerns regarding member eligibility and claim status, please reach out to our Customer Service department at 800-635-0579.
For questions regarding logging in, access, setting up new users, or navigating the website, please reach out to NaviNet directly at 888-482-8057.
Are all MA plans the same?
All MA plans are not the same. Each MA plan is customized by private healthinsurance companies and follow guidelines provided by the federal government.Most MA plans offer benefits beyond Original Medicare.
Is Original Medicare better than Medicare Advantage plans?
Many MA plans have low out-of-pocket costs and premiums. In many plans, hospitalsand providers are paid the same as Original Medicare. MA plans place an emphasison preventive care and include many benefits not offered by Original Medicare, whichhave been shown to improve the health and well-being of MA members compared toOriginal Medicare.
Do MA plans have a limited network of doctors?
Many MA plans provide care using networks of providers and specialists, but allnetworks are not equal. PPO MA plans allow you to use doctors, hospitals and otherhealth care providers outside the network without a referral.
Does MA coverage travel with you?
Many MA plans offer robust travel networks of providers allowing flexibility acrossthe country.
Do MA plans have high out-of-pocket costs?
Original Medicare does not pay for the entire cost of care, so costs are passed to thebeneficiary. Many MA plans include predictable cost-share amounts in the form ofcopays or coinsurance for covered Medicare services, which are applicable toward anannual maximum out-of-pocket amount. Original Medicare does not offer the samefinancial protection.
Do MA plan benefits change annually?
MA plan benefits can change annually. The Annual Enrollment Period (AEP), which runsfrom Oct. 15 to Dec. 7 each year, is an opportunity for Medicare beneficiaries to evaluatetheir plan and determine if changes are necessary for the upcoming year.
If you choose an MA plan, do you need constant referrals and approvals?
Again, not all MA plans are created equal. Many MA plans do not require referrals tosee specialists. MA plans may require prior authorization for some services to ensurethe care is medically necessary and the proper payments are made. Many of thesecontrols do not exist in Original Medicare, making health care more expensive overall.
