Care Gaps

NaviNet care gap alerts

NaviNet provides care gap alerts, in addition to eligibility and claims status information. These alerts allow you to find missing recommended services (care gaps) before a member comes in for a visit.

When you check a member's eligibility and benefits, an alert box will appear if the member has a care gap.

You can view and print the Care Gap Worksheet (PDF), which lists the last service date of the missed measure and the rule that was used to determine the gap. Place the Care Gap Worksheet in the member's chart for consideration during the visit. If the care gap indicates “response required,” you can go to the clinical documents link in the eligibility and benefits screen to resolve the care gap and submit your response through NaviNet. For more information on the submission of a care gap response, see the NaviNet Care Gaps Response Form Provider Guide (PDF).

You can also view and print a comprehensive care gap report for your practice. You can choose reports based on a specific measure (e.g. preventive health screen) or all measures. To access this information, choose the Report Inquiry option from the transaction menu, and then select Clinical Reports.

If you have any questions or feedback about this NaviNet feature, please contact your account executive (PDF).