Navina for Health Plans

Turn payer intelligence into provider action at the point of care

Navina embeds actionable insights directly in the EHR to improve risk accuracy and quality outcomes, reduce operational costs, and boost value-based performance.
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77
%
acceptance rate of AI diagnosis suggestions
86
%
weekly active providers
43
%
increase in identified diagnoses
1
in
3
Care gaps closed based on evidence found by Navina
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Drive accurate risk adjustment, prospectively

Navina's AI surfaces HCC opportunities within the provider EHR workflow, backed by traceable clinical evidence and MEAT-aligned documentation for accurate and efficient coding at the point of care.

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Strengthen RADV readiness with encounter-based documentation

With every diagnosis linked to the clinical encounter and documented proactively with defensible evidence, Navina gives plans a stronger audit trail and greater confidence going into any review.

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Improve provider engagement, remove workflow friction

Navina is built for the way clinicians work, embedding directly into existing EHR workflows and eliminating the friction that limits adoption. Health plans gain the provider engagement needed to turn strategy into consistent, measurable execution across the network.

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Boost Stars
and HEDIS®
performance

Care gaps surfaced in the EHR workflow help providers address quality opportunities during the visit. With 1 in 3 care gaps closed based on evidence found by Navina, plans can improve quality metrics at scale.

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Manage your
network in
real-time

Navina provides real-time visibility into provider activity, HCC capture, and quality outcomes across the network, helping teams plan proactively, identify gaps earlier, and act before opportunities are lost.

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Automated generation of documentation

Supports physicians by automating diagnosis and visit documentation. Navina uses state-of-the art generative AI to automatically suggest MEAT-compliant documentation.

Payer intelligence. Provider action. One connected workflow.

“One of our doctors was coming into the clinic at 4 or 5 AM every day to prep charts. Navina eliminated that extra work, and in essence, it changed her life.”

Dr. Keith Fernandez
Chief Clinical Officer, Privia Health
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“We were searching for a solution because we felt like we were leaving RAF on the table when it came to payer programs and value-based care.”

Carrie Jernigan
Director of Clinical Quality, Ogden Clinic
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“With Navina’s help we were able to bridge the gap in communication to build trust not only with our payers but within our entire organization.”

Ericka Bauman
Director of Quality Analytics, Your Health
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Industry-leading, clinician-first AI

Best in KLAS Clinician Digital Workflow
Clinician Digital Workflow
Gold Stevie Winner
AI/ML Solution for Healthcare
MedTech Breakthrough Award
Best Use of AI in Healthcare
KLAS Top 20 Emerging Solutions
Top 20 Emerging Solutions of 2024
CB Insights Digital Health 50
Top 50 - Clinical Intelligence Category
CB Insights AI 100
Top 100 AI Companies in the World