How Do You Find Trusted NaviNet Outsourcing Services?

NaviNet is a payer-provider collaboration portal from NantHealth. NantHealth’s published figures put sponsorship at more than 40 health plans, with a nationwide network of over 450,000 users signing in to work with those plans. When a health plan sponsors NaviNet, its provider workflows are free to the practice: claims, Eligibility and Benefits, authorizations, and patient and practice documents, plus drug authorizations powered by CoverMyMeds. Paid NaviNet AllPayer subscriptions extend the same screens beyond sponsoring plans: Eligibility and Benefits for 1,270+ plans, Claim Status Inquiry for 660+ plans, and claim submission on the top tier.

The catch is that a portal answers questions; it does not do the work. Someone still has to sit in NaviNet before each clinic day and run the eligibility list, chase claim statuses one payer at a time, watch the authorization queues, pull plan documents, and then re-key what they learned into the PM and EMR. In most practices that someone is the same front desk that is also answering phones. This page is about staffing that gap.

Practices whose payer mix leans on NaviNet-sponsored health plans, which is where the portal earns its keep: the front desk checks NaviNet for eligibility before clinic, billing checks it for claim status after submission, and referral staff watch its authorization and document queues in between. It also fits billing teams that hold a NaviNet AllPayer subscription and need someone to actually work the 1,270+ plan eligibility screens and 660+ plan claim status screens they are paying for, instead of letting the subscription idle.

Our specialists run NaviNet’s Eligibility and Benefits workflow against tomorrow’s schedule, every business day. For sponsoring plans that includes plan detail like visit maximums and visits remaining; with an AllPayer subscription the same screen reaches 1,270+ commercial, Medicaid, and Medicare plans. We record what the portal returns, flag coverage problems before the patient arrives, and enter the verified coverage into your PM so the claim starts clean.

For plans that sponsor authorization workflows in NaviNet, we submit and track authorizations and referrals in the portal, follow each request until the plan posts a decision, and document the approval number, valid dates, and units where your schedulers and billers will actually see them. Auth work started in a portal and finished nowhere is one of the most common denial stories we walk into; a dedicated owner ends it.

Practices on the AllPayer Ultimate tier can submit claims through NaviNet to 8,100+ organizations. Where that is part of your workflow, our billers prepare and submit claims, reconcile what was sent against your PM, and work anything the payer kicks back. Where your claims flow through a separate clearinghouse instead, we simply work claim status and denials in NaviNet and leave submission where it lives today; we staff your workflow, we do not redesign it around ourselves.

The most valuable half of portal work happens outside the portal: the eligibility result entered on the patient record, the auth number attached to the visit, the claim status noted on the account, the document filed to the chart. Our specialists are trained to finish the loop in your PM and EMR after each NaviNet action, in your format and your fields, which is what keeps the portal from becoming a parallel universe your billing system cannot see.

HIPAA-trained staff. Business Associate Agreements executed with every client. Workflows designed to support HIPAA compliance, with SOC 2 Type II attestation, ISO 27001:2022, $5M E&O and cyber liability coverage, and named individual credentials with full audit logs. Read the complete program, including our corporate structure and evaluation framework, at HIPAA and Security at Staffingly.