We focus on out-of-network medical bills, so you don’t
have to
Naviguard® provides the expert support needed to understand out-of-network balance medical bills and resolve them.
To learn more, watch this video.
What we do
Relieve your frustration with a pathway to resolution
Out-of-network medical bills can be expensive and sometimes catch you off guard. Naviguard® is here to provide clarity, reduce frustration, and reach a solution where everyone benefits — patients pay market-value prices and providers receive timely payment for their work.
Naviguard brings insight, understanding, and decades of health care and health insurance experience to our members medical billing situations. By expertly managing all the details and interactions with providers, Naviguard can help members find resolution on their out-of-network medical bills, so you can breathe a sigh of relief.
See how Naviguard works for Members
Benefit from a trusted resource who can manage the entire medical bill resolution process from start to finish. Let us take the responsibilities for negotiation and independent dispute resolution off your plate, saving you time and stress while helping keep your employees happy and healthy.
Protect your employees
On behalf of patients and employers, we work with providers and healthcare professionals to quickly solve out-of-network issues, using advanced industry pricing resources to negotiate an appropriate resolution that avoids arbitration and expedites your out-of-network payment.
See how we helpThe Problem
The concerns are clear
Out-of-network billing can be confusing and costly. That’s because navigating your way through an unfamiliar process takes a great deal of time, creates stress, and may not even result in clear answers.
57%
of patients in America have been surprised by an out-of-network bill.1
2 out of 3
Americans are worried about affording unexpected medical bills.1
70%
of out-of-network medical bills come from situations that won’t be covered by the No Surprises Act.2
1 Kaiser Family Foundation, Data Note: Public Worries About And Experience With Surprise Medical Bills, 2/28/2020.
2 Based on UHC commercial claims data 2020-2021.
Our Solution
Naviguard has answers
Get the out-of-network support you need with Naviguard.
Valued Ally
We serve over 5.3 million members, supporting employers and their employees by making the process of managing out-of-network costs less confusing for everyone.
Trusted Insight
We understand out-of-network billing, inside and out. Count on our decades of experience, our focus on ever-changing regulations, and our national and local market expertise to help reach a resolution.
Meaningful Results
“This was such a blessing. My advisor explained everything and sent us the info we needed. She did all the work and kept us in the loop. Such a relief to know this has been taken care of, and I could put my focus on my husband’s health rather than fight with providers.”*
Victoria, Arizona
We have a 76% success rate in negotiating lower out-of-network bills with providers for our members.
Based on Naviguard’s engagement with its members during January 2021 through January 2023. Negotiation success rate is based on claims negotiated to less than billed charges. Negotiation success rate may vary and is not a guarantee of future results.
“I’ve never heard of this service until I had a large balance on an out-of-network ambulance bill. Somehow this bill was reduced by nearly $500. Thank you!!”*
Caden, Arizona
“Thank you so much!! This is such a huge weight off my shoulders!”*
Jennifer, Illinois
Naviguard has handled hundreds of thousands of cases to help resolve out-of-network medical bills.
“Definitely will recommend Naviguard, they were extremely helpful and took over the issue right away and fixed it. Thank you, thank you!!!!!!!!!!!!!!!!!”*
Patricia, Arizona
“In addition to a favorable outcome, the overall customer experience was excellent. First, it was easy to get a representative on the phone without going through several annoying phone menus. The interactions via email were simple to use and very straightforward.”*
Kimberli, South Carolina
“Very easy to work with and they reduced my medical bill significantly.”*
Karl, Tennessee
Naviguard engages with thousands of providers across the United States in over 173 care specialties.
“They were able to resolve my issue in a very favorable way. I just gave them the information and they did all the work.”*
Lucas, New York
Over $75 million in total member savings to date.
Savings measured by taking the difference between the aggregate out-of-network original billed amount and the aggregate final allowed amount under the plan during January 2021 – January 2023 for cases where Naviguard was engaged by a member to negotiate a balance bill on the member’s behalf. Includes disputed claims but excludes denied claims.
Get To Know Naviguard
We’re the experts people look to for out-of-network billing solutions
Resolving out-of-network bills is our sole focus – and we do it well. Naviguard leverages decades of expertise and unrivaled market data to bring clarity and protect patients when they need it most. Because at the end of the day, better information leads to better outcomes.
Resources
Helpful resources to bring clarity
Use these resources to learn more about out-of-network medical bills, how to deal with them, and how to avoid them.
What is Out-Of-Network Billing?
Out-of-network means that no contract exists between the provider and insurance company. In many cases, out-of-network providers charge prices significantly higher than market rates.
Learn More
Explanation of Benefits (EOB) Explained
It says, “This is not a bill.” So what exactly is an EOB, or Explanation of Benefits. This article breaks down everything you need to know about your EOB.
Learn MoreOverview of the No Surprises Act
On January 1, 2022, the No Surprises Act (NSA) went into effect, prohibiting medical balance bills for many — but not all — out-of-network services. However, there are still situations when patients are not covered by the NSA – and that’s where Naviguard comes in.
Learn More
Contact Us
We’re here for you.
Have a question for Naviguard or want to learn more about our out-of-network medical bill services?