One Connection. More Than 1,270 Health Plans.
A suite of secure APIs that lets providers, revenue cycle companies, and third-party vendors connect directly to more than 1,270 health plans from within the systems they already use — automating transactions, eliminating manual lookups, and driving operational costs down across the healthcare industry.
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- 1,270+Health plans reachable through a single API gateway
- Real-TimeEligibility, benefits, and claim status transactions
- DaysTypical SaaS onboarding from implementation to live
The Cost of Manual Transactions
Payers and providers share the burden of a tremendous volume of administrative interactions that still happen manually — adding inefficiency to every workflow and introducing potential delays in patient care.
The U.S. healthcare system spends roughly $83 billion on the administrative processes tracked by the CAQH Index. An estimated $18.4 billion — about 22% of that annual spend — could be saved by transitioning to fully electronic transactions.
Source: 2024 CAQH Index®
Benefits for Stakeholders Across Healthcare
Whether you submit transactions, build the tools that power them, or process them at scale, NaviNet AllPayer APIs connect your systems to the nation’s largest payer-provider network.
Providers & Revenue Cycle Companies
Connect your core EMR and billing systems directly to all payers, virtually eliminating manual or double data entry and outbound telephone inquiries. Fully automated workflows let offices focus on clinical priorities while improving the speed and accuracy of billing and collection — and the overall member experience, outcomes, and cost of care.
Third-Party Vendors
Connect to NaviNet to access and share data across our network of providers, powering enhanced payer-provider collaboration for revenue cycle management, care coordination, and value-based care initiatives.
Health Plans
Serve your largest provider organizations with the rich information already available in the NaviNet portal — delivered automatically through the systems they choose, without adding administrative burden.
Key Features
A secure, HIPAA-compliant gateway built to scale your transactions and connect cleanly into the tools your teams already rely on.
Automated Transaction Sets
Easily connect to and automate eligibility & benefits and claim status inquiry transactions, reducing outbound calls and manual lookups.
HIPAA-Compliant Gateway
A secure gateway to health plans across Commercial, Medicare, Medicaid, and more — sharing data efficiently while improving billing and collection accuracy.
Developer Tools
Access full API details and connect and test quickly, so your team can integrate with confidence.
Greater Connectivity, Interoperability, and Speed
Your applications only need to connect to our API gateway — we handle the health plan connectivity, so vital information flows where the work actually happens.
- Securely reach 1,270+ health plans in real time for more cost-effective workflows
- Reduce outbound telephone inquiries and manual lookups for faster, more accurate billing and collection
- Support prior authorization, care coordination, quality, and value-based care initiatives
- Scale and expand with the flexibility to evolve as your business grows
Let’s Talk APIs
For pricing or more information, email us at [email protected] or request the API overview here.
