NaviNet Open logo

NaviNet Open

by NantHealth · Since 2007
No reviews yet
ActiveAvailable globally
Quick facts
VendorNantHealth
Year launched2007
StatusActive
LocationWinterville, NC, United States
Countries servedGlobal
Languages9
IntegrationsN/A
Free tierN/A
Free trialN/A
Contact salesN/A

About NaviNet Open

NaviNet Open is a healthcare communication software from NantHealth that supports patient and provider interactions. It provides secure messaging, claims management, and eligibility verification so healthcare professionals can efficiently manage workflows. The platform integrates with existing electronic health records (EHR) and practice management systems, allowing for simplified communication between stakeholders. This helps to reduce administrative burdens and improve patient care coordination. Key capabilities: secure messaging claims management eligibility verification integration with EHRs workflow management Best for: healthcare providers that need efficient communication and administrative solutions.

NaviNet Open by NantHealth is a healthcare interoperability platform purpose-built to strengthen collaboration between payers and providers while significantly reducing administrative burden. Designed with a provider-friendly, payer-focused philosophy, the platform delivers real-time, bi-directional data exchange that supports critical administrative, financial, and clinical workflows across the healthcare ecosystem. At its core, NaviNet Open acts as a centralized access point where providers can interact with multiple health plans through a single, intuitive interface. Key capabilities include eligibility and benefits verification, claim status inquiry, claims management, authorizations, referrals, and secure document exchange. These workflows are highly configurable, allowing payers to align them with specific business rules, compliance requirements, and branding needs. The result is faster turnaround times, fewer phone calls and paper-based processes, and improved provider satisfaction. One of NaviNet Open’s strongest differentiators is its proven scale and reliability. With more than 25 years of nationwide delivery and zero reported system outages, the platform is trusted for mission-critical healthcare operations. Its HIPAA-compliant, HITRUST-certified architecture ensures security and regulatory compliance, while single sign-on and multi-plan access simplify daily use for provider offices.

Pros & Cons

Pros
  • Strong payer–provider interoperability.
  • Significant reduction in administrative costs.
  • High provider adoption and usability.
  • Robust compliance and security standards.
  • Highly configurable payer workflows.
Cons
  • Primarily healthcare-focused use case.
  • Complex setup for smaller organizations.
  • Dependent on payer participation.

Features

Key features

Multi-Payer Provider Access – Enables providers to access workflows from multiple health plans through a single nationwide network.
Bi-Directional Data Exchange – Supports real-time, two-way healthcare data flow between payers and providers.
Configurable Payer Workflows – Allows payers to design custom workflows aligned with business and operational goals.
Eligibility & Benefits Automation – Delivers real-time insurance verification, copay, deductible, and coverage details.
Claims Management Suite – Digitally manages claim submission, status tracking, adjustments, and appeals.
Electronic Authorizations – Streamlines prior authorization requests with HIPAA-compliant online submissions.
Referral Management – Enables informed, value-based referral decisions with real-time referral data.

Additional features

Plan Central Branding – Customizable payer-branded portal for announcements, workflows, and resources.
Document Exchange (DocX) – Secure, real-time exchange of administrative, financial, and clinical documents.
Claim Status Inquiry (CSI) – Automated access to claim receipt confirmation, adjudication, and payment details.
Claims Submission Integration – Routes claims digitally via clearinghouse partnerships.
Claims Attachments & Appeals – Supports digital submission of attachments, investigations, and appeals.
Authorization Status Tracking – Provides real-time updates on approvals, denials, and information requests.
Custom Authorization Logic – Configurable fields, business rules, and third-party integrations.
Referral Visibility – Guides providers to in-network and cost-effective specialists.
Single Sign-On (SSO) – Enables multi-plan access with a single login.
Advanced Analytics – Provides insights into workflow usage, performance, and efficiency.
Workflow Automation – Reduces manual processes across payer-provider interactions.
Compliance Management – Platform management handled by NantHealth for regulatory adherence.
HIPAA Compliance – Ensures secure handling of protected health information.
HITRUST Certification – Meets stringent healthcare security and privacy standards.
Consultative Support – Dedicated advisory services for implementation and optimization.

Pricing

Free trial
Free version
Request a quote
Promo Offer

Countries & Languages

Global
Countries served
9
Interface languages
63
Billing currencies

Interface languages

EnglishSpanishFrenchGermanItalianPortugueseDutchJapaneseChinese

Billing currencies

🇺🇸USD🇪🇺EUR🇬🇧GBP🇯🇵JPY🇦🇺AUD🇨🇦CAD🇨🇭CHF🇨🇳CNY🇸🇪SEK🇮🇳INR🇸🇬SGD🇰🇷KRW🇷🇺RUB🇿🇦ZAR🇹🇷TRY🇧🇷BRL🇲🇽MXN🇳🇿NZD🇭🇰HKD🇳🇴NOK🇩🇰DKK🇵🇱PLN🇹🇭THB🇮🇩IDR🇲🇾MYR🇭🇺HUF🇨🇿CZK🇵🇭PHPBGNHRKISK🇰🇪KES🇳🇬NGN🇦🇪AED🇸🇦SAR🇨🇱CLP🇵🇪PEN🇨🇴COP🇮🇱ILS🇪🇬EGP🇵🇰PKR🇻🇳VNDIQD🇧🇴BOB🇺🇾UYURSD🇺🇦UAHQARAMDGELMUR🇹🇿TZS🇬🇭GHSKZTKWDBHDOMRLBP🇪🇹ETBAZNCRC🇨🇲XAF🇸🇳XOF

No reviews yet

Be the first to drop a review

Alternatives to NaviNet Open

Candidate Direct Marketplace logo

Candidate Direct Marketplace

Candidate Direct Marketplace is a recruitment software from CareerBuilder that helps employers connect with potential…

Hospital IS logo

Hospital IS

Hospital IS is a healthcare management software from Eyone Medical designed to improve appointment management.…

Heckercare logo

Heckercare

HeckerCare is a healthcare management platform from Heckerbella Limited that supports efficient healthcare operations. It…

HealthStation HMIS logo

HealthStation HMIS

HealthStation HMIS is a health management information system software from HealthStation Ltd that supports healthcare…

Health 360 logo

Health 360

Health 360 is a health management software from Health 360 that provides an integrated solution…

Wilco Solutions IT Multi Speciality Hospital logo

Wilco Solutions IT Multi Speciality Hospital

Wilco Solutions IT Multi Speciality Hospital is a hospital management software from Wilco Solutions IT…

Spot something wrong or outdated?

Suggest a correction — a reviewer verifies every change.

Often compared with NaviNet Open

Compare any two tools →
Candidate Direct Marketplace logo
Candidate Direct Marketplace
Hospital Management
0.0
Hospital IS logo
Hospital IS
Hospital Management
0.0
Heckercare logo
Heckercare
Hospital Management
0.0
HealthStation HMIS logo
HealthStation HMIS
Hospital Management
0.0