NaviNet

Connecting Providers and Health Plans

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Overview

NaviNet is a secure, multi-payer web portal that enables providers to exchange vital administrative and clinical information with health plans in real-time. While part of a broader suite of tools, it offers functionality for checking eligibility and benefits, viewing claims, and submitting authorizations and referrals to its network of connected payers.

✨ Key Features

  • Multi-Payer Portal
  • Eligibility and Benefits Verification
  • Authorizations and Referrals
  • Claim Status and Management
  • Clinical Document Exchange

🎯 Key Differentiators

  • Strong relationships with major health plans, particularly Blue Cross plans
  • User-friendly portal interface
  • Focus on real-time information exchange

Unique Value: Simplifies provider workflows by offering a single, easy-to-use portal to connect and transact with a large network of health plans.

🎯 Use Cases (3)

A single portal for providers to interact with multiple health plans Submitting authorization requests Checking patient eligibility and claim status

✅ Best For

  • Used by a large percentage of physician offices in the United States.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Practices needing advanced automation or integration directly within their EHR

🏆 Alternatives

Availity Waystar Change Healthcare

Often considered more user-friendly for basic transactions compared to some other large clearinghouses, though may have less advanced features.

💻 Platforms

Web

🔌 Integrations

Major national and regional health plans (e.g., Blue Cross Blue Shield plans)

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (N/A tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ HITRUST

💰 Pricing

Contact for pricing
Free Tier Available

Free tier: Core access is free for providers, sponsored by health plans.

Visit NaviNet Website →