NaviMedix Announces NaviNet Real-time Financial Responsibility Solution Suite

Business Wire, Oct 29, 2007

Addresses Provider Need for Real-time Financial Data at Time of Service for Accurate Collections, Rapid Reimbursements; Helps Plans Improve Efficiency and Satisfaction

PHILADELPHIA -- NaviMedix, the leader and innovator in automating provider communications with health plans, care management companies and other health industry participants, announced today the NaviNet([R]) Real-time Financial Responsibility Solution Suite. The offering helps health plans improve efficiency and provider satisfaction by giving providers the real-time financial data they need for accurate assessment of patient financial responsibility, allowed reimbursement from insurance and members' available funding sources (such as HSAs and HRAs). The Suite ensures that providers collect the right amount from the right source at the time of service and helps offices better predict their accounts receivables. Suite features, the most recent of which was released in July 2007, are available to nearly all 240,000 providers in the NaviNet community.

This comprehensive solution is integrated into NaviNet, NaviMedix's industry-leading provider communications platform, and includes a wide range of functionality that offers providers a complete financial responsibility picture in real-time, including:

* Allowed charges based on providers' specific payer contracts, including patient- and site-specific information.

* Patient responsibility calculator that enables providers to easily determine how much the patient will owe based on benefit and dollar accumulators. It also provides patient co-pay and deductible information for each specific service.

* Real-time funds availability that allows providers to easily understand their options for collecting payment from the patient.

The solution suite delivers financial responsibility information to the provider in a context-driven environment, as part of a staff member's typical workflow. For instance, prior to a patient office visit, a user may perform an inquiry via NaviNet about that patient's insurance eligibility and benefits. NaviNet will supply information about the patient's insurance coverage, financial responsibility and available funding for the rendered services.

"Getting real-time financial information via our eligibility and claim status workflows is important to running an efficient office and staying competitive, especially as high-deductible consumer plans become more prevalent," said Phil DeAngelis, director, Reimbursement Services, Main Line Health System. "NaviNet gives us a huge advantage by immediately providing us with the financial information we need, without having to contact the health plans or inconvenience, or cause stress to the patient."

The NaviNet Real-time Financial Responsibility Solution Suite addresses providers' need to know patient financial information at the time of visit for members served by health plans without real-time adjudication capabilities. For plans whose adjudication systems can process claims in real-time, the Suite can support adjudication rather than estimation. NaviNet's financial responsibility capabilities help plans to increase provider satisfaction by enabling a cleaner, more efficient claims process, reducing costly communication threads associated with complex secondary insurance or payment responsibility issues, and enhancing the appeal of their benefit packages to employer groups in a highly competitive market.

"NaviMedix creates strategic solutions that effectively address the financial challenges that health plans and providers face today," said Tim Hargarten, president and chief executive officer of NaviMedix. "Our real-time financial responsibility capabilities offer the market a broadly available and practical solution. We've embedded features into NaviNet that are implemented by health plans and used by providers across the country - right now. They provide an immediate solution to an industry waiting for real-time adjudication to become widely available."

Providers can sign up for NaviNet at the Medical Group Management Association (MGMA) conference, NaviMedix booth #124, or by visiting www.aboutnavinet.com. NaviNet is sponsored by NaviMedix, health plans and other partners. Access to certain NaviNet features is dependent upon geographical location, individual health plan approval and other factors.

About NaviMedix

NaviMedix is the leader and innovator in automating provider communications with health plans, care management companies and other industry participants, enhancing efficiency, reducing costs, improving relationships and optimizing care. NaviMedix offers automated information exchange, technology and services that deliver integrated business and clinical information from multiple health plans and partners directly into the provider office. Today, over 240,000 healthcare providers across the country use NaviMedix's NaviNet([R]) solutions and services to collaborate with the nation's leading health plans and healthcare service organizations. For more information, please visit www.navimedix.com or call us at 617-715-6000 or 800-805-7569.