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NaviNet Health Plan Solutions

NaviNet Sponsor and Enterprise solutions enable health plans to access over 800,000 providers nationally. Our solutions solve real business problems by combining innovative technology with our team’s combined decades of industry experience.

NaviNet Sponsor offers health plans rapid connectivity and a starter set of transactions, including Eligibility and Benefits Inquiry, and Claim Status Inquiry. This solution enables health plans to meet essential provider electronic connectivity needs and add new transactions at their own pace.

The result:

  • Low-risk, low-cost implementation
  • Ability to meet basic provider self-service requirements
  • Reduction in operating costs
  • Established foundation for future, more advanced capabilities such as clinical messaging and alert capabilities

NaviNet Enterprise enables health plans to leverage out-of-the-box transactions or develop unique offerings that extend beyond industry standards to create additional value. This is accomplished through a partnership with NaviNet; one in which we develop long-term solutions that support a plan’s strategic initiatives.

The result:

  • Ongoing, consultative relationship
  • Comprehensive provider integration, and deployment planning and support
  • Insightful utilization reporting, and proven marketing and communications campaigns
  • Clinical messaging and alert capabilities
  • Significant reduction in costs while freeing IT resources to concentrate on core competencies

Compare these solutions

 

  NaviNet Sponsor NaviNet Enterprise
NaviNet Account Services
  • “Plug-and-play” network access
  • Shared account and program management
  • Account management quarterly planning
  • Strategic, consultative approach
  • Dedicated account and program management
  • Executive team quarterly planning
NaviNet Health Plan Solutions
  • Productized foundational transactions with ability to expand transaction suite over time
  • Pre-defined workflows and screens
  • Collaborative development of strategic vision for provider Web site based on health plan’s business drivers
  • Pre-defined or proprietary transaction workflows and screens
NaviNet Integration Services
  • Pre-defined connectivity, protocols and message formats
  • HIPAA X12 EDI
  • HTTPS / SOAP
  • VPN over public Internet
  • Fully tailored approach to connectivity, protocols and message formats
  • Ability to leverage standard integration approach or customize
  • Single sign-on available
NaviNet Platform
  • Health plan branding
  • Registration and enrollment
  • Provider network communications
  • Account administration
  • Health plan branding and premium content placement within NaviNet
  • Registration and enrollment
  • Provider network communications
  • Account administration
NaviNet Network Support
    Secure, scalable and reliable services:
  • Hosting
  • Data center operations
  • Hardware provisioning
  • Technical operations
  • Production systems health monitoring
    Secure, scalable and reliable services:
  • Hosting
  • Data center operations
  • Hardware provisioning
  • Technical operations
  • Production systems health monitoring
   

 

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