NaviNet
What is NaviNet?
NaviNet is an easy-to-use, free, web-based platform that links providers to AmeriHealth Caritas District of Columbia. 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. If you're not a NaviNet user, learn more about NaviNet.
Upcoming events
New and refresher provider orientations
Dates:
Wednesday, June 11, 2025
Wednesday, August 13, 2025
Wednesday, October 8, 2025
Wednesday, December 10, 2025
Time: 3:00 p.m. – 4:30 p.m.
Please click here to register.
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)
- Identify and improve HEDIS gaps
- NaviNet Medical Authorizations Training Guide (PDF)
- NaviNet Medical Authorizations Frequently Asked Questions (FAQ) (PDF)
- Tutorial Video — Prior Authorization Inquiry Process
- Tutorial Video — Prior Authorization Submission Process