Jeff Heyman on November 12, 2015

Three Things Providers Want from Health Plan Provider Portals

Headshot of Jeff Heyman, Product Marketing Director at NaviNet

How many times do you check your email each day? I know, trick question, right? You’re probably thinking is “continuously” a choice? And when you check your email, how many different applications do you use? One? Two? Possibly even three?

Now, imagine that instead of clicking into Outlook on your desktop, your email is scattered across a dozen different websites. Each time you get an email, you need to visit a specific site for that item, remember your login credentials, re-orient yourself to the user interface for that site, and respond to that email. And then repeat. For every new email.

This clunky experience is not far off from what staff at provider offices have to do daily when navigating various health plan provider portals to verify eligibility and perform other day-to-day administrative tasks. In fact, our recent survey of providers revealed that 43% use more than 6 portals a week to check eligibility and benefits. 10% report using more than 16 portals per week! How frustrated might you be from this process?


This pain-point is one of the many insights gleaned from a recent provider network survey. NaviNet regularly surveys our 450,000 provider office users that span all 50 states and a wide array of specialties in order to gain insights that help NaviNet and our health plan partners to collectively improve provider satisfaction and collaboration.  In this particular survey, we reached out to over 4200 provider office end-users, and explored what they are looking for in a provider portal.

In addition to exposing how many different health plan provider portals are involved in daily administrative tasks, our analysis of the survey results also revealed three key characteristics that providers are looking for in effective provider portals.  In order to encourage provider portal utilization, portals must drive:

  1. Workflows That Work
  2. The Right Information at the Right Time 
  3. Streamlined Electronic Payer-Provider Collaboration

1. Workflows that Work

Responses from our survey showed that provider satisfaction with health plan portals isn’t just a function of what features are available within a portal. Satisfaction, and adoption, are impacted by how the portal as a whole fits among the workflow for everything else the provider office staff does each day. Dr. Jacob Reider, ONC’s former Chief Medical Officer, coined a term that is very appropriate for what portal users are experiencing: “hyperportalosis”.  Although he was referring to the proliferation of patient portals, the idea is the same. Health plans often have their own provider portals, which requires providers to log into multiple sites and search in different ways to find the clinical and administrative information they need to do their everyday work.  Providers are clearly frustrated, as demonstrated by the comment below:

“It’s aggravating to have to keep up with so many websites and different passwords that you have to change constantly”

Respondents also echoed a theme that we continually hear in our user research which is that providers would like:

“multiple plan access in one spot with one password.”

Both these comments indicate a high-demand for multi-payer solutions, where users can have a one-stop shop and a consistent workflow for all of their payer collaboration needs.

2.  The Right Information at the Right Time 

The survey also gave a glimpse into why, despite growing capabilities of provider portals, provider office staff still pick up the phone to call their health plans for information. Above all, “insufficient benefit information for my specialty” rose to the top, accounting for 38% of the calls to health plans. Similarly, we heard pains around referral management, with providers lacking sufficient information from health plans to be able to help their patients navigate increasingly narrow networks. With this feedback, the survey shows that provider portals must offer rich, accurate, up-to-date information to stave off many would-be calls.

3.  Streamlined Electronic Payer-Provider Collaboration

A final area explored by the survey was how provider portals improve efficiency in day-to-day tasks. We found that despite the electronic collaboration that portals inherently provide between health plans and providers, many administrative tasks still rely on fax and snail mail. As an example, when health plans request a “chart pull” to support quality documentation and medical necessity review,  70% of respondents are spending 2+ hours per week responding to these requests, primarily relying on fax and mail. Yet, 79% of survey respondents would prefer to electronically send this information via the provider portal.

Survey Results Are Consistent Across Providers

The needs and pain-points voiced by office staff were remarkably consistent across states, specialties, and types of healthcare organizations that we surveyed. Here at NaviNet, we're excited that our work to address these provider pain points with our NaviNet Open applications can have significant impact on the overall effectiveness of payer/provider collaboration

Want to learn what your health plan can do to improve these stats? Check out our recent webinar "How to Combat Hyperportalosis in Your Provider Network."

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Tags: health plans, Healthcare IT

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NaviNet, part of NantHealth, is America’s largest interactive healthcare network. Our flagship multi-payer provider website is built on deep payer integration and the innovative use of technology to deliver real bottom-line value for both payers and providers.