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Technology solutions

AmeriHealth Caritas offers leading-edge technology tools that reduce paperwork, coordinate medical records and streamline claims processes—leaving practitioners more time to focus on patient care.

NaviNet

NaviNet is a one-stop service that supports every provider's clinical, financial and administrative needs. From care gap alerts to claims status updates, NaviNet puts information in providers' hands at the time of care—enhancing productivity and value. Using NaviNet, providers can check a member’s eligibility and claim status in real time, 24/7.

Clinical messaging

Clinical messaging notifies providers of care gaps while checking a member's eligibility. If there is an unmet care need, such as an overdue breast cancer screening or well-child visit, a care gap alert will appear on the provider's computer screen. This technology alerts providers to any missing health care service a patient needs. A special clinical messaging reporting feature allows primary medical providers (PMPs) to manage and identify specific diseases within their patient population, such as diabetes or asthma.

Claims processing

AmeriHealth Caritas aims to make claims processing simple and streamlined. Providers only need Web access to file a claim. We process both paper and electronic claims and accept claims via electronic data interchange (EDI). Corrections to diagnosis codes, billing and more can also be submitted through EDI.

Emdeon WebConnect

For submitting paper claims, AmeriHealth Caritas offers a no-cost tool that streamlines direct claim entry. Emdeon Provider WebConnect is a personalized, secure Web service that assists small-to medium-sized practices in reducing costs while improving overall workflow.