NaviNet Open Advanced Referrals - like other NaviNet Open applications - is built on 16+ years of best practice and experience with the nation's leading health plans. This leading payer-provider collaboration application helps health plans guide clinician offices toward the optimal cost and quality provider referral sites. NaviNet Open Advanced Referrals empowers provider offices to submit referrals in real time, choosing the best quality specialist at the most affordable cost, meeting the needs of the patient, provider and health plan.
Drive care coordination and cost savings
- Real-time referral response allows health plans with narrow networks to simplify referral submission and inquiry for provider offices resulting in less phone calls
- Easily configurable terms to optimimize the network by customizing which providers are displayed when submitting referral requests
- Decision support allows health plans to recommend the best value specialists to the referring provider and is available through electronic transactions resulting in greater operational efficiency
- A user-friendly portal enables providers to easily submit, modify, and check the status of referrals
Improve Provider Engagement
Improve collaboration to thrive in a world of value-based care
- Value-based contract measures can be met more easily, increasing profitability and incentive measures for both health plans and providers
- Greater information, such as health plan benefit tiers, preferred providers and patient financial responsibility are available electronically at point of care, empowering provider offices with the tools to make the best referral decision based on cost and quality
- Real-time transmission of quality based information enables care coordinators to make the best decisions that support quality care performance
Are you getting the most out of your referrals?
There is a high cost and quality disparity between providers.
The cost of services can be
depending on where a referral is made.
NaviNet Open Advanced Referrals
Increases provider engagement & patient satisfaction
Reduces claims expense
Improves pay for performance measures
- Hospital-based versus freestanding outpatient imaging services |
- Regents Health Resources |
- May 05, 2011
"In my position as a Referral Coordinator, I use NaviNet on a daily basis. It's so easy to use and I am able to quickly access the data I need, such as eligibility and benefits information. Cumbersome paperwork and phone calls are replaced with easy, secure, online transactions."
- L. Lilja, Referral Coordinator
5 Trends in Value-Based Reimbursements
NaviNet Open Advanced Referrals can positively impact profitability and performance incentives within value-based contracts. With 75% of providers already participating in one or more value-based reimbursement programs, it's critical to understand the Five Trends driving the future of value-based reimbursements so that you have the right collaborative tools in place to drive high-quality, cost-effective patient care and to succeed in the post reform era of healthcare.Download Now