Administrative Efficiency

NaviNet Open presents richly detailed information including tiers, services and benefits — answers to all questions a provider might ask.

The need:

An information portal that reduces the calls to your provider call center and eliminates associated manual processing.

The solution:

Web-based transactions that are richer, more complete and higher quality than clearinghouse-based options. Let’s face it: Portal solutions designed only to meet HIPAA standards don’t stop calls to your offices. NaviNet Open supports plan-specific integrations that address the all areas of HIPAA — integrations that are robust and flexible enough to ensure providers take advantage of them. NaviNet’s standard-level transactions are so reliable, some health plan customers mandate their providers use NaviNet for key interactions rather than call them. Let NaviNet shoulder the burden of first-level support calls, emails and chats. Lower phone calls and less manual processing by the payer leads to lower cost. And an easy-to-use system with detailed information and multiple payers leads to satisfied providers.

The bottom line:

Reduce calls and save money.

Clinical Information Delivered in Real-Time

NaviNet Open delivers relevant, real-time clinical alerts that make value-based care possible.

The need:

Securely transmit key clinical data to providers at the right time to help providers optimize care and enable accountable-care contracts.

The solution:

Allow reimbursement transactions to trigger the delivery of rich clinical information at the right time. NaviNet Open delivers clinical data to the provider when they check for insurance eligibility. NaviNet Open listens for “events” across the provider network, identifies clinical information related to those events, and delivers that information to the provider so they can take action. Information can originate from multiple sources, including payers, claims information, HIE, EMRs and/or informatics engines. NaviNet Open transmits this information securely — and allows the provider to securely distribute the information to appropriate team members. One system is all you need.

The bottom line:

Adding clinical information to reimbursement transactions improves outcomes, lowers costs and increases patient satisfaction.

Flexible, Extensible Architecture

Customize, scale and extend your platform using NaviNet's open integration framework.

The need:

One piece of software that accommodates your wide-ranging and ever-changing information needs.

The solution:

A platform that’s scalable, configurable and integrates with third-party software. NaviNet Open is designed to fit your needs, now and in the future. Add new members. Reconfigure your settings. Add third-party solutions using open APIs. NaviNet Open accommodates membership growth, new products, new plans and evolving contracts. As a scalable and extensible platform, NaviNet Open is able to integrate with systems necessary to support payer initiatives using published standards. Now, you can fully embrace accountable care practices by relying on quality metrics, population health management and outcomes promotion.

The bottom line:

Reduce total cost of ownership with a single solution that grows with you.

Full-service, Standardized Product

Lower total costs through faster implementation, predictable maintenance costs and continuous product upgrades.

The need:

One system to access all health- and benefit-related information — that’s easy to learn and maintain.

The solution:

A single software product that covers all your information needs, comes with a robust support infrastructure and is frequently updated to reflect the latest healthcare policies and trends. We’re constantly updating and fine-tuning NaviNet Open, to the benefit of all our existing customers. All NaviNet customers gain access to a suite of services: Account Management, Operational Support, Marketing, Launch & Deployment, and End-User Support. You’ll also get continuing product updates to ensure your plans comply with all future federal mandates.

The bottom line:

Reduce total cost of ownership with a single, frequently updated product.

Provider Engagement

NaviNet’s user-friendly, multipayer portal has become the one-stop shop for providers.

The need:

Engage providers in meaningful exchanges of critical information.

The solution:

A communications platform that’s user-friendly, widely adopted and delivers the right information to the right person at the right time. We know health plans are looking for a partner who offers more than a web-enabled overlay for clearinghouse transactions. They want a partner whose accurate and complete information helps engage providers in meaningful exchanges of critical information. NaviNet stands out in the industry by offering targeted delivery of rich communications and robust workflows. Our real-time healthcare communications network delivers the right information to the right person in the provider office at just the right time, ensuring maximum effectiveness of health plan data and maximum efficiency for the provider office and its staff. NaviNet Open drives engagement by supporting delivery of clinical information as well as enhanced HIPAA-transaction content. Our impressive national network of health plans makes us a one-stop destination for providers.

The bottom line:

Increase provider adoption and satisfaction.

Top-flight Customer Service

From dedicated account managers and deployment teams to training modules and 24-hour helplines, NaviNet is your full-service strategic partner.

The need:

Robust customer support from initial set-up through ongoing implementation.

The solution:

Customer service that covers your needs. Our job is ensuring your success. We work hand-in-hand with customers from initial implementation to ongoing needs. You’ll have access to:

  • An account manager who will direct resources to help you achieve your goals
  • Ongoing training on NaviNet Open’s variety of tools and services
  • Assistance for marketing to your provider networks
  • Support developing and managing content on your “Plan Central” home page so you can communicate with your providers
  • A 24-hour help line

There’s a call center for providers and a team devoted to making sure they not only know how to use NaviNet Open, but are engaged on the platform. Our operational support is backed by a fully secure, EHNAC-certified data center. Members of our senior executive team are accessible and attuned to your feedback. We want to be your strategic partner for all your information needs. Our dedication to taking care of our customers is what sets us apart. Just ask our existing customers: In a recent customer satisfaction survey of our implementations, we averaged 4.9 out of a possible 5.

The bottom line:

Comprehensive, long-term support you can count on.

Are you ready for Payer-Provider Collaboration?