Navina for Health Plans

From payer data to
point-of-care impact

Turn health plan data into AI-powered insights your coders, quality teams, and provider network can act on in one connected workflow. Capture more HCCs, close gaps earlier, and improve Stars and quality performance all on one platform.
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86
%
Weekly provider adoption
77
%
of AI suggestions accepted
+
0.278
Average RAF lift
1
in
3
Quality gaps closed on Navina evidence
KLASS award logo
Trusted
digital health award logo
Recognized
Hipaa logo
Private
AICPA Soc
Secure
ISO 27001 award logo
Certified
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Automate and streamline your data flow

Access a seamless, bi-directional flow of data that pushes actionable insights to your coder and quality teams, as well as providers, and brings validated clinical evidence back to your health plan in real time.

Bring coders and quality teams to the table

Move your coding and quality teams from the sidelines to the point of care by empowering them with purpose-built workspaces for reviewing evidence, adding codes and gap notes, and pushing them directly to providers before a visit.

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Drive action at the point of care

Eliminate barriers to physician adoption by embedding directly into EHR workflows, driving the engagement needed for consistent, measurable execution across your network.

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Capture risk right the first time

Move HCC capture upstream by surfacing AI-suggested conditions in provider workflows in real time, capturing more during the visit and eliminating retrospective code chasing.

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Strengthen RADV readiness 

Back every diagnosis with source-level evidence for a stronger, defensible audit trail. Give your teams real-time access to the clinical record behind every submitted diagnosis, no more manual chart chasing.

Optimize network performance

Leverage real-time visibility into provider activity, HCC capture, and quality outcomes across your network, to help plan proactively, identify gaps earlier, and act before opportunities are lost.

Payer data. Provider action.
One connected workflow from one source of truth.

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Loved by providers. Built for health plans.

"Navina's platform stands out because of its ability to reduce the burden on physicians while also giving a more appropriate history of the patient's conditions. It backs up every insight and diagnosis with clinical evidence at the time of a patient visit."

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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Ready to turn payer data into point-of-care impact?
Stars
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