NaviNet Announces NaviNet Doc Xchange for Secure, Efficient and Cost-Effective Medical Document Sharing

Leader in Healthcare Communications Joins CMS esMD Program to Support Electronic Document Exchange; Reduce Costs and Payment Lag Time by Eliminating Paper Processing

BOSTON--(BUSINESS WIRE)-- NaviNet, America’s largest real-time healthcare communications network, today announced NaviNet Doc Xchange, a new solution to enable electronic document exchange among healthcare providers, insurers and other recipients. NaviNet Doc Xchange offers secure, efficient and cost effective electronic medical document exchange, eliminating mail- and fax-based submission to streamline common healthcare processes. NaviNet Doc Xchange will be available in August as a Health Information Handler (HIH) under the first phase of the Centers for Medicare & Medicaid Services’ (CMS) electronic submission of medical documentation (esMD) pilot program.

CMS’ esMD pilot program was developed to help providers submit medical documentation to CMS electronically, reducing cost and revenue cycle time by minimizing and eventually eliminating paper processing, mailing and faxing of medical documentation. The esMD program is designed to streamline a process that takes time away from patient care and gives providers a new mechanism for information delivery.

During Phase 1, which goes live later this summer, Review Contractors will continue to send medical documentation requests via paper mail and providers will have the option to electronically send medical documentation to the Review Contractor that requested it.

Today, providers do not have an electronic channel to submit medical documentation to CMS or to check the status of submitted information. Mailing or faxing paper-based supplemental documentation, which is required for up to 15 percent of all claims and in the case of Medicare Recovery Audits, can cost provider offices and hospitals up to $12 and $30, respectively, per request. Further, payments to providers can be significantly delayed.

NaviNet is an HIH that uses the Nationwide Health Information Network (NHIN) standards, and NaviNet Doc Xchange will serve as a secure esMD gateway. Using NaviNet Doc Xchange, which integrates with third-party electronic medical records (EMRs) and NaviNet EMR, providers can easily send medical documents that are pulled from an EMR in a standard format or uploaded to the solution in an unstructured format (.PDF or image). NaviNet Doc Xchange also brings transparency to the documentation delivery process as providers can determine when submissions were received and if they have been processed correctly.

“NaviNet is eager to work with CMS to address a significant provider and insurer pain point; we believe we’re uniquely positioned to increase participation in the CMS esMD program as physicians, clinicians and healthcare providers in all 50 states already use NaviNet regularly to connect with health insurers including Medicare,” said John Kelly, chief information officer, NaviNet. “We developed NaviNet Doc Xchange by leveraging our vast expertise in provider office workflows. The service incorporates electronic document delivery into a platform that providers across care settings are comfortable using. As provider and insurer needs evolve, we see an opportunity for NaviNet Doc Xchange to support additional administrative, financial and clinical information delivery for providers, insurers and health information exchanges across the country.”

NaviNet Doc Xchange will be initially available through NaviNet Insurer Connect, the industry’s leading multi-payer portal. The solution provides a technology foundation enabling providers to send content-agnostic medical documentation quickly and easily to a variety of trading partners: other provider offices and hospitals, insurers, government organizations, health information exchanges and more.

Providers using NaviNet already have a direct connection to Medicare through NaviNet Medicare Eligibility and NaviNet Extended Eligibility, low-cost online services that provide direct links to Medicare and more than 300 insurers, eliminating manual processes to obtain patient information. NaviNet Doc Xchange will be available in 2011 bundled with NaviNet Medicare Eligibility and NaviNet Extended Eligibility.

About NaviNet

NaviNet, America’s largest real-time healthcare communications network, securely links leading health plans, industry partners and the government to hundreds of thousands of physicians, clinicians and other healthcare professionals. More than 70 percent of the nation’s physicians are enrolled in the NaviNet Network, which touches 121 million covered lives. NaviNet’s solutions and services for unified patient information management (UPIM) address the full lifecycle of healthcare data management by providing single-source access to patient-centric administrative, financial and clinical information to reduce costs, increase efficiencies and improve quality of care. The NaviNet solution suite includes NaviNet Insurer Connect, NaviNet Mobile Connect, NaviNet EMR, NaviNet PM, NaviNet Medicare Eligibility and NaviNet Extended Eligibility. For more information, or to sign up for NaviNet, please visit or call 617-715-6000 or 800-805-7569. Connect with us on our blog, Twitter, Facebook and LinkedIn.


Schwartz Communications
Mercedes Carrasco, 781-684-0770
[email protected]

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