Connect with your entire provider network
Does your organization prioritize value-based care?
Your ability to communicate with providers through an inviting, flexible, and extensible platform is critical.
NaviNet is a secure multi-payer portal built on one of America’s leading payer-provider collaboration platforms. Payers and providers can exchange vital administrative, financial, and clinical information in real-time.
Payers leverage NaviNet Open applications to help communication, boost operating efficiency, cut costs, and improve provider satisfaction.
Facilitate provider engagement and generate trustworthy, actionable data throughout the continuum of care delivery.
NaviNet has allowed me to work more efficiently by providing timely resources and systems that are user-friendly and intuitive.
Jason W., Coding & Billing Manager, Nally Family Practice
Discover NaviNet Open payer solutions
Magnify your brand and keep providers informed
Your NaviNet Open Plan Central page is unique to you and your brand. Providers visit this centralized access point to view all workflows and resources available from your health plan in NaviNet.
You control what appears on Plan Central. Update and customize content at any time, post announcements and alerts, and share network information and resources.
I have been using NaviNet for the last 10 years. I can honestly say that it has made my work life much easier and more efficient.”
David F., Clott, Matthew – Constructive & Reconstructive Surgery
Exchange critical documents with providers
Support bi-directional exchanges of information to engage providers during vital clinical workflows with NaviNet Open Document Exchange.
Exchange administrative, financial, and clinical information in real-time—including care gaps, fee schedules, risk adjustment information, quality measurement data, and performance reports.
Thrive in a world of value-based care by providing access to critical information at the point of care. Learn more.
I have been using NaviNet for over 20 years and found it to be the most user friendly and informative website. This is the first website that I use to train new staff and always my ‘go to’ for all types of information.”
Debbie S., Office Manager, Hess Physical Therapy
Simplify the insurance verification process
Deliver membership verification and insurance coverage information to provider offices in real-time. Tailored to your organization’s business needs, NaviNet Open Eligibility and Benefits displays copayment, deductible, and benefit information, and is designed to easily extend to display more detailed information.
$12.8 Billion
Estimated annual savings opportunity for automating the eligibility & benefits workflow.1
37/member
Average number of eligibility & benefit verifications annually.1
Automate responses to claim status requests, reducing costs
Give provider offices access to detailed financial and claim status information in real-time, eliminating the need to call your organization directly. NaviNet Open Claim Status Inquiry aligns health plan and provider interests by automating the delivery of claim receipt confirmation, adjudication status, and important payment details.
$15.68 vs $2.07
Estimated cost of a manual claim status inquiry per transaction versus per electronic transaction.1
169 Million
Number of phone calls yearly between providers and health plans to verify claim status.1
Manage the entire lifecycle of a claim, digitally
Providers can submit claims directly to payers with the NaviNet Open Claims Management suite. NaviNet leverages clearinghouse partnerships to streamline claim submission. Claims are efficiently routed to health plans through existing clearinghouse connections, eliminating phone calls, costly paper claims, and other manual processes associated with claims follow-up, correction, and resubmission.
NaviNet Open Claims Management can help you save money and boost provider satisfaction through automation of claim submission, adjustments, attachments, investigations, and appeals.
169 Million
Number of phone calls yearly between providers and health plans to verify claim status.1
$2.3+ Million
Estimated annual savings potential to fully automate claims management.1
$25/per transaction
Additional cost for claims requiring rework.2
Exchange instant HIPAA-compliant authorization requests and inquiries
Using NaviNet Open Authorizations can aid in increasing provider trust, satisfaction, and overall network relations by shifting authorizations from a costly and time-consuming manual process to a streamlined online form submission with electronic follow-up.
NaviNet Open Authorizations lets providers access the most up-to-date authorization information—such as status updates, approvals or denials, and requests for additional information—online.
Configure fields, add additional business logic, and integrate with third-party applications. Add-on workflow capabilities better support necessary requirements.
Only 28%
Number of authorizations that are fully electronic.1
$3,600+
health plans savings per 1,000 transactions by shifting to electronic prior authorizations.1
Facilitate informed referral decisions
NaviNet can enable provider offices to make more informed referral decisions and aid in value-based contract success by providing detailed referral information. NaviNet Open Referrals lets provider offices submit and access referrals in real-time, guides patients to the best specialist at the most affordable cost, and equips staff with more information to navigate complex sub-networks while you optimize in-network or value-based referrals.
1 in 3
Number of patients referred to a specialist every year.3
$10M
Amount, on average, every primary care physician controls of downstream healthcare spend.4
Innovate and achieve success with our partnership
Our customers know how important it can be to leverage technologies and data that improve patient outcomes and help them focus on member health. We believe that it’s equally important to leverage community and collective knowledge to drive innovation. As a NantHealth customer you’ll receive a dedicated team of consultants, trusted advisors, support, and training.
Full-service strategic partnership
You’re never alone on your journey with us. Leverage the experience of our consultative teams to ensure your success.
Foster collaboration that promotes a deep understanding of your business’ landscape and goals and receive ongoing support, product improvements, and cost savings.
Unlock innovation
Focus internal resources on other innovation projects, leaving platform management and compliance assistance to us. Gain continuous product improvement without sacrificing speed-to-market.
Trusted advisors
Access a cross-functional team who act as trusted advisors to provide guidance and recommendations from initial implementation through upgrades
and enhancements.
Entrust us to manage all areas of technical operations, including key performance and scaling initiatives, system monitoring, and detailed system analytics and reporting.
Dedicated support and training
Access numerous support and training resources, such as live phone support, case management, videos, user guides, administrative guides, and online chat. Address end-user needs quickly, alleviating substantial call support demands.
Provider adoption and engagement
With NaviNet, we hope everyone will benefit from NaviNet’s goals of providing increased operational efficiency, streamlined communication, and significant savings. NaviNet can help you Reduce manual processes across your organization through decreased administrative complexity and increased transparency, with the aim of leading to timely, higher quality, more cost-effective care that directly benefits patients.
Providers rave about these popular features
With one login, NaviNet connects providers with the health plans that they use every day. Users love the convenience of accessing all of their payers through an all-in-one portal. They trust NaviNet to deliver insurance information in real-time and our simple navigation and efficiency boosting features keeps them signing back in.
Health plan partner workflows are accessible for free
Providers can access your NaviNet Open workflows for free with their NaviNet account! Depending on your implementation, workflows may include claims, eligibility & benefits, authorizations, patient and practice documents, and more. Intuitive navigation and seamless integration with existing payer workflows deliver a uniform experience across all health plans.
I use NaviNet almost everyday. It’s easy to use and saves me so much time.”
Kisha P., Office Coordinator, BenchMark Physical Therapy
Eligibility and benefits checks are quick and convenient
Providers stay up-to-date with real-time patient eligibility and benefits checks, including detailed information about covered services. Plus, they enjoy the convenience of our virtual member ID cards. With NaviNet, deciphering outdated and worn-out member ID cards are a thing of the past!
I have been using NaviNet for over 20 years and found it to be the most user friendly and informative website. This is the first website that I use to train new staff and always my ‘go to’ for all types of information.”
Debbie S., Office Manager, Hess Physical Therapy
Patient-first navigation increases efficiency
Providers experience patient-first navigation with NaviNet Patient List. They save time by accessing all of their patients in a searchable list with instant verification of eligibility and benefits. They can also jump directly into payer workflows, like claim status inquiry.
I have been using NaviNet for the last 10 years. I can honestly say that it has made my work life much easier and more efficient.”
David F., Clott, Matthew – Constructive & Reconstructive Surgery
Electronic drug authorizations are seamless
NaviNet partners with CoverMyMeds® to deliver NaviNet Drug Authorizations at no cost to providers, including electronic submissions for any drug under any health plan—including Medicaid and Medicare.
NaviNet has allowed me to work more efficiently by providing timely resources and systems that are user-friendly and intuitive.”
-Jason W., Coding & Billing Manager, Nally Family Practice
All-In-1 Portal
With one log in, providers connect with all the health plans they transact with every day, including yours.
1,200+ Health Plans
Join our nationwide network of health plans and tap into our extensive provider base.
Clean Claims
Cleaner claim scrubbing and validation helps cut back on inefficiencies, reducing the need for provider outreach.
$25 Billion
How much the healthcare industry can save each year by adopting fully electronic administrative transactions.1
66 Seconds
The average time it takes a provider to sign in and complete an E&B inquiry with NaviNet.
Safe, secure, streamlined
For NantHealth, security is a priority. NaviNet is HIPAA compliant and HITRUST certified, having met key regulations and industry-defined requirements.
1 2022 CAQH Index Report
2 Medical Group Management Association (MGMA)
3 Mehrotra A, Forrest CB, Lin CY. Dropping the Baton: Specialty Referrals in the United States. The Milbank Quarterly
4 Mostashari F, Sanghavi D, McClellan M. Health Reform and Physician-Led Accountable Care: The Paradox of Primary Care Physician Leadership. JAMA
