A solution for Payer-Provider Collaboration
Streamline communications across a single, integrated platform that makes working together more efficient. The NaviNet product suite offers a range of solutions for payers and providers so that you can choose the options that are right for you. NaviNet Open, our offering for payers, delivers a comprehensive set of provider portal workflows available to your whole network. Providers have free access to sponsoring health plan workflows, and with our AllPayer Access and Medicare Access, can extend their use to interact with the payers that cover all or most of their patients.
826,000+ user accounts are registered on the NaviNet platform.
- NaviNet Open
- Drug Authorization
- Population Health Management
- AllPayer Access
- Medicare Access
- AllPayer Plus
NaviNet® Open is one of America’s leading payer-provider collaboration platforms—a secure, multi-payer web portal that lets payers and providers exchange vital administrative and clinical information in real-time.
- Improves provider relationships by granting centralized—and real-time—access to information regarding patients’ eligibility and benefits, claims management, authorizations, referrals, and administrative, financial, and clinical information exchange.
- Reduces time spent on complaint mitigation and troubleshooting on both sides—simplifying workflows, minimizing internal resources labor, and reducing friction between your payer organization and providers.
- Minimizes time and money spent on the phone and performing other manual administrative tasks, dramatically increasing operational efficiencies for both parties.
Via our long-standing collaboration with CoverMyMeds®, NantHealth delivers NaviNet Drug Authorizations—available for free to every provider registered on the NaviNet Portal. Drug authorizations grants provider offices access to every payer and pharmacy benefit manager while adding another element to the streamlined value of the NaviNet platform.
- Saves time for providers by ensuring that patients get the drugs and pharmacy services they need.
- Offers the clarity, simplicity, and efficiency of having the drug authorization workflow side by side with everything in the NaviNet Open portal: eligibility and benefit inquiries, claims management, claims authorization, referrals, administrative and clinical information delivery, and more.
NantHealth’s Population Health Management help payers and providers deliver on value-based care initiatives. As part of the NaviNet platform, population health management provides a full 360-degree picture of the patient while enabling better workflow between providers, payers, hospitals/healthcare networks and patients.
- Increases provider transparency: The “at-a-glance” user interface helps payer and provider care management teams take advantage of and inject actionable insights into their existing workflow without having to juggle separate portals or screens. Increasing transparency means payers can reduce risk while better aligning with providers, making sure patients get the right care at the right time.
- Streamlines engagement: Actively engaging patients and assigning care managers increases patient responsiveness and wellness resulting in happier providers and patients at lower costs.
- Informs referrals: By automating communications, including the transfer of health plan and patient clinical data and care information, primary care givers can refer the patient to the highest quality provider in the network and reduce network leakage.
NaviNet AllPayer Access delivers eligibility, benefit, and claim status information for 1,000+ commercial and state Medicaid plans, opening a single door to a world of information that typically consumes significant time to access. Gain all the benefits of NaviNet Open, plus extended access to additional health plans.
- Displays eligibility and benefit information in a consistent and accessible way, facilitating smoother information exchange and accelerated workflows.
- Offers an easy-to-navigate, secure, and cost-effective way for providers to expand access to any health plan they do business with, reducing time spent searching for—or providing—information.
- Provides payer COB teams with an online channel to verify their members’ insurance coverage information with other health plans.
Broaden the NaviNet umbrella with NaviNet Medicare Access, an add-on that extends eligibility to Medicare, with all of the same one-stop-shop advantages that you’re used to.
- Offers a simple solution for providers that cover Medicare patients.
- Provides users with the same, easy-to-use interface and unparalleled access – without requiring multiple logins.
For providers looking to extend their NaviNet use even further—and reap the greatest benefits—NaviNet AllPayer Plus is the gold standard. Gain access to an additional 1,000+ commercial and state Medicaid plans, plus Medicare.
- Combines the benefits—and ROI—of NaviNet Open, NaviNet AllPayer Access, and NaviNet Medicare Access, into one comprehensive bundle.
- Offers the ultimate solution for providers looking to improve operational efficiency to the highest degree.
- Saves time, money, and frustration for payers and providers alike, while improving the patient insurance experience.
Hear from our Customers
How has NaviNet positively impacted the way you do your work?
I have been in healthcare working since 1998 and work in areas that would access NaviNet regularly. I can’t imagine my job without it – it’s a complete time saver and is super accurate with the information that is provided.-Jessica S., Practice Administrator, Northeast Physical Rehab Office
NaviNet is the best system I use for my work. I get things done more quickly efficiently and accurately. It truly is a quality product.-Lori Y., Office Manager, Northeast Chiropractic Office
NaviNet has allowed me to work more efficiently by providing timely resources and systems that are user-friendly and intuitive.-Jason Walker, Coding & Billing Manager, Nally Family Practice