Naviguard brings clarity to healthcare billing for patients, employers, and providers.

1 in 5 insured adults has had an unexpected bill from an out-of-network (OON) provider in the past two years.

OUR SOLUTION

We are a champion for our members who are affected by out-of-network medical billing.

Naviguard offers a best-in-class solution for out-of-network billing issues that combines proprietary market-based pricing data, robust member advocacy, and enforcement against egregious billing practices.

2 in 3 adults

worry about unexpected medical bills.

70% of people

who get an out-of-network bill did not know they were receiving out-of-network services.

57% of Americans

have been surprised by an out-of-network bill.

Market-Based Pricing

Naviguard’s proprietary pricing methodology is derived from a number of factors, including fair market rates. We work to ensure that providers are compensated appropriately for the services they provide, and that consumers and employers can expect reasonable prices. Because we utilize only market-based factors and not the out-of-network billed charges, Naviguard drives more savings than competitive programs.

Arbiter of Fairness

While there are various reasons that providers may choose to remain out-of-network, Naviguard’s experts are dedicated to identifying trends that may contribute to increased medical costs or deceptive billing practices. We look for trends in provider behavior that may increase out-of-network utilization or large balance bills. We then take action to change or stop these behaviors, which could include provider education, contracting, investigation, flagging providers, issuing formal warnings, redirecting care, or even legal action.

Member Advocacy

Naviguard advocates for employers and consumers via dedicated, one-on-one relationships. UnitedHealthcare members who contact Naviguard for balance billing support will be assigned to a dedicated Advisor who owns the issue through final resolution, including negotiating a bill reduction with the provider when needed. Our secure, online member portal tracks cases from start to finish, allowing the member to engage on their time using their preferred method of communication. We use our deep industry knowledge and best-in-class technology to make it as easy as possible for members to get the support they need.

We Support

Patients

We are healthcare billing experts. We’ll help you understand if you’ve been billed correctly, help you figure out what your options are, and give you tips to avoid future OON bills.

Information For Patients
We Support

Employers

As a venture of UnitedHealthcare, we help companies make sure their employees are protected from egregious billing practices and receiving quality care, ultimately helping employers keep costs down in the process.

Information For Employers
We Support

Providers

Our proprietary pricing model manages costs and mitigates risk.

Naviguard’s claim pricing is objectively derived, market-based, and defensible—factors that are critical in helping to mitigate arbitration events.

Information For Providers

About Us

Your ally and champion against out-of-network bills.

We know this industry.
We hear your frustration.
We have your back.

We’re committed to using our vast repository of industry knowledge to help health care consumers navigate the uncertainty and frustration of surprise out-of-network bills, and to help ensure that health care providers are performing fair and ethical practices.
We are proud to offer our expertise free of charge. You have enough to worry about.

About Us

Contact Us

We’re here to help.

Our experts are ready to lend their vast industry knowledge to help solve your issue.

Contact Us

What Is the Process?

It’s our goal to simplify what can feel like a very complicated process. We will help you navigate your OON bill and options in just a few straightforward steps: