BOSTON, MA--(Marketwired - Sep 23, 2014) - NaviNet, Inc., America's largest real-time healthcare communications network community, serving more than 420,000 users and 39 health plans, today announced the general availability (GA) of NaviNet Open, its next-generation healthcare communications network integrating value-based reimbursement and clinical workflows. Given the tighter collaboration between payers and providers in the post-reform era, health plans leverage NaviNet Open to enable the exchange of critical clinical and administrative data among members of the healthcare ecosystem in real time to improve cost management and overall patient care.

Beta Program Customer QualCare, Inc. successfully completed its Beta Program and is live in production on NaviNet Open. It chose NaviNet Open as its next-generation payer-provider platform solution to support patient-centered clinical workflows and value-based reimbursement models. These capabilities, which make NaviNet Open the most advanced network technology platform in healthcare today, were designed based on the best practices of the NaviNet multi-payer portal.

The NaviNet Open layered architecture provides the extensibility, flexibility, and scalability necessary to accommodate change and promote growth as health plans launch new businesses and products. In addition to the base platform, NaviNet Open offers core applications, value-based network applications, configuration and administrative tools, and open APIs for easy connectivity, integration, and application development.

"Payer-provider collaboration is essential to innovation and growth," said Karthik Ganesh, executive vice president, chief operating officer and chief information officer of QualCare, Inc. "The NaviNet Open communications network helps to enable data transparency between payers and providers, which builds trust and prevents potential disputes over performance. That trust is further bolstered as patient outcomes begin to improve, leading to additional pay-for-performance revenue for the hospitals and practices."

"This is a major new product that can help everyone who's trying to change healthcare for the better," said Frank Ingari, president and chief executive officer of NaviNet, Inc. "Our engineers have integrated 15 years of best practices in provider communication with the best modern approaches to extensible software design. NaviNet Open is a true platform based on open APIs, designed to support third-party and in-house developers, and supporting a rich application set that will delight our many devoted users and make life easier for healthcare consumers."

Complex Event Processing Allows "Listening" to Key Events, Empowering a Targeted Action in Response
Complex event processing software is embedded in NaviNet Open and helps companies and government agencies of all sizes to take action based on real-time intelligence. It empowers payer-provider collaboration through the injection of proactive, real-time clinical information. NaviNet Open's customers can "listen" to key events taking place on the network and take targeted actions in response. If, in a simple example, a health plan is most interested in "listening" for a member eligibility check-in order to determine if there is important patient-specific clinical information to be delivered, NaviNet Open provides rule-based tools to aid in the detection of such events and the subsequent delivery of rich clinical content such as the patient clinical summary, care considerations, and program enrollment forms. The integration of clinical information with key reimbursement information is the key to success in value-based contracts and accountable care.

Value-Based Network Applications Arm Healthcare Network Community for Success
NaviNet is developing a series of value-based network applications that map to the needs of health plans as they negotiate and institute value-based contracts with provider organizations. These include Clinical Document Exchange and Advanced Referrals and Authorizations. Quality metrics, accurate coding and reimbursement, network tier management and steerage, and proactively tackling care considerations are all necessary for success in today's changing landscape.

New NaviNet Open User Interface Speeds Targeted Network Communications
The new NaviNet Open User Interface (UI) represents the most modern, multi-browser, easy-to-use, thoroughly tested navigation in the industry. Information is easy to find, the multi-payer capabilities are highlighted, and health plans can brand themselves and distribute targeted content to groups of provider users based on many factors, such as zip code, products or lines of business served, networks, and more. NaviNet understands the complexity faced by provider offices and has built this interface to simplify tasks and present information in a logical, easy-to-use manner. This one-stop shop for the distribution of content and information that health plans can easily manage to communicate with their provider networks reduces reliance on secondary, more costly channels.

Announcing the Launch of the New
In conjunction with its GA release, NaviNet launched its new website,, to align its digital presence with the company's repositioning as a product company. The interactive design is dynamic and engaging. Specific audience segments such as payers, providers, users, partners, and those seeking to learn more about the fast-moving healthcare industry will find the site intuitive and easy to navigate. Some key features include the following:

  • Interactive Home Page. Access helpful videos, tools, latest news, and events where you can meet with NaviNet executives.
  • User-Friendly Navigation. Visitors can quickly find the information they need through the intuitive site menu.
  • Industry Resources. Thought leadership content delivered by a wide array of NaviNet community customers, partners, and industry leaders discusses future industry trends and solutions through the NaviNet blog (hyperlink), webinars, and much more in the Resources Library (link)
  • Responsive Design. The site supports multiple browsers and mobile devices for easy access anywhere, anytime.

For more information and to experience the new website, please visit

About NaviNet
NaviNet is a real-time healthcare network communications company. The company's flagship multi-payer provider communications platform connects 60% of the providers in the United States with 39 health plans. The network is sponsored largely by healthcare payers, who benefit from the efficient communication of common provider-to-payer workflows, such as insurance verification, reimbursement investigation, referrals, and authorizations. NaviNet Open is a next-generation payer-provider communication network that integrates reimbursement-related and clinical workflows. It consists of a series of layers: a platform, a set of network services, a suite of reimbursement-related and clinical applications, and a set of tools that customers can use to configure and customize the system. For more information, please visit our new website

Contact Information:

Media Contact:

NaviNet, Inc.
Laura McCaughey
(o) 617.715.6431
(c) 617.610.4224