NantHealth for Payers
Helping payers thrive in a changing healthcare system
Connect your provider network, automate authorizations, and surface evidence-based care decisions, through technology that simplifies workflows for both sides of the exchange.
The cost of inefficiency is staggering, and recoverable
Industry research has quantified the savings opportunity from digitizing healthcare workflows. The numbers are large enough that even partial wins matter.
- $25B
Estimated amount the healthcare industry could save annually with electronic transactions.1
- $183B
Direct cancer-related healthcare spending in the U.S., a major driver of payer cost.2
- 25%
Percentage of U.S. healthcare spending attributed to waste, much of it administrative.3
- 1,270+
Health plans connected through the NaviNet network for real-time provider exchange.
Plans don’t just need more software, they need fewer disconnected ones
Health plans are under immense pressure to ensure timely, quality, and cost-effective care across their membership. Achieving that requires technology that simplifies workflows for both sides of the payer-provider exchange.
- Simplify provider workflows to reduce call-center volume
- Surface evidence-based decisions at the point of care
- Improve care coordination across the network
What changes when your provider network is on the same platform
Most payer-provider friction comes from fragmented systems, manual workflows, and gaps in information. A unified portal closes all three at once.
Fragmented payer-provider exchange
- Provider call-center volume strains operations and inflates cost
- Authorizations delayed by faxed forms and missing data
- No consistent UX across your provider network’s lines of business
- Treatment plans approved without evidence-based guardrails
- Care gaps and quality measures sit in siloed systems
A unified payer-provider exchange platform
- Real-time bi-directional exchange across the provider network
- Streamlined authorization workflow with evidence-based decisioning
- Consistent, modern UX across every payer your providers work with
- Treatment plan validation against the latest oncology guidelines
- Care gaps and quality data surfaced at the point of care
Two platforms. One simpler way to work with providers.
NantHealth’s payer-facing platforms solve the two highest-leverage problems in network operations: provider exchange and treatment plan decisioning.
NaviNet®, your network’s daily workflow
The NaviNet suite enables payers and providers to share vital administrative and clinical information in near real-time through a single multi-payer portal. The same portal your providers already log into every day for eligibility, claims, and document exchange.
- Bi-directional information exchange with your provider network
- Increase operational efficiency by automating manual processes
- Eliminate redundancy by shifting to electronic authorizations
- Real-time eligibility, claim status, and benefit details
- Care gap and quality data at the point of care
Eviti Connect®, evidence-based authorizations
Eviti Connect helps payers better manage costs for oncology and autoimmune conditions through a streamlined authorization workflow that facilitates expedited care for members. Decisions backed by the most comprehensive evidence library in oncology.
- Streamlined authorization workflow for oncology and autoimmune conditions
- Reduce care costs through evidence-based decision support
- Eliminate inappropriate or off-guideline care
- Support value-based care arrangements with member-level transparency
- Expedite treatment plan validation in real time
Trusted by leading payers across the country
NantHealth’s platforms move administrative and clinical data between health plans and provider networks at scale, securely, in real time, and with the certifications your operations and compliance teams require.
Where payers see the biggest impact
Across cost, care quality, network engagement, and compliance, the workflows that move the needle live in one platform.
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Reducing administrative cost
Replace manual call-and-fax workflows with electronic transactions, recovering a meaningful share of the $25B annual industry savings opportunity.
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Faster, smarter authorizations
Surface evidence-based treatment guidance at the moment of authorization, cutting cycle time for oncology and autoimmune cases.
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Better provider relationships
Give your provider network one consistent portal across every line of business instead of dozens of disconnected systems.
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Improved member outcomes
Surface care gaps and evidence-based recommendations at the point of care, where they actually change outcomes.
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Compliance & security at scale
HITRUST CSF certified, NCQA accredited, CAQH CORE certified, the same compliance bar your largest peers rely on.
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Visibility into network performance
Real-time analytics on transactions, authorizations, and engagement give your operations team actual answers, not month-old reports.
The compliance and certifications your operations team expects
Independent third-party validation that NantHealth’s platforms meet the highest standards in healthcare security, quality, and interoperability.
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HITRUST CSF Certified
Meets the highest healthcare security and privacy standards
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NCQA Accredited
Health utilization management accreditation
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CAQH CORE Certified
Eligibility, claim status, payment & remittance
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Trusted by Leading Plans
Powering payer-provider exchange across the U.S.
Ready to simplify your provider network experience?
Schedule a 20-minute walkthrough with our payer solutions team. We’ll demo real workflows from your specialty mix and member population, no slides.
