Frequently asked questions
Have questions about resolving out-of-network health care costs that aren’t answered here? Don’t hesitate to reach out.
Naviguard® brings clarity to the complicated world of out-of-network billing costs. If you have questions, we have answers.
Naviguard is a UnitedHealthcare service that uses advanced analytics and effective strategies to review and resolve out-of-network balance medical bills.
Our advisors provide information, guidance and education through the entire bill resolution process. If needed, our expert negotiators directly negotiate with health care providers to resolve any disputes related to balance medical bills.
Naviguard has trained experts who negotiate directly with health care providers on behalf of members to resolve out-of-network balance medical bills. Our negotiators leverage extensive industry and provider knowledge, combined with market data, to determine the appropriate rate for medical services.
Naviguard manages the details and all interactions with providers, saving members and employers time and frustration. On average, it takes 30-45 days to negotiate a case initiated by a member.
Naviguard was created to help reduce the amount you may owe for medical care from out-of-network providers. Our experts will review your case to determine if the provider balance billed you.
If you were balance billed, our negotiators may contact the provider on your behalf to try to agree on a lower amount. Naviguard does all the negotiating and will keep you updated throughout the process.
For example, Naviguard can negotiate excessive charges from specialists, X-rays, lab analysis and other common out-of-network care situations. You don't need to do anything except complete a few simple steps to get started.
If you received care from an out-of-network provider, look at the Explanation Of Benefits (EOB) you get from UnitedHealthcare. If the amount you owe is higher than your cost share, you may receive a balance medical bill from the provider. When you receive your bill, call us before you pay it so we can review it, and if necessary, negotiate it with your provider. Read more about EOB.
Naviguard services are available to UnitedHealthcare members in participating health plans at no additional cost. Members have access to Naviguard’s advocacy and medical billing negotiation services as part of the benefits supplied by their employer.
To find out if you have access to Naviguard, call the member phone number on your health plan ID card, or ask your employer.
Call the member phone number on your health plan ID card to activate the Naviguard benefit. Tell the UnitedHealthcare Member Service representative you've received a balance medical bill from a provider and would like to work with Naviguard to resolve your bill. Get started in 3 simple steps.
For other inquiries, please submit your questions online or call us toll-free at 1-866-218-5205 (Monday-Friday, 9–5 p.m. CT). Please leave a voice mail message and a representative will return your call within 2 business days.
A network health care provider typically charges less than one that’s out-of-network.
To find an in-network provider, please visit my.uhc.com®.*
*For UnitedHealthcare members.
Depending on the claim and the employers' needs, we offer various package offerings to serve the dynamic needs of our employers. Contact your UnitedHealthcare representative for more details.
Contact your UnitedHealthcare representative for more information about Naviguard’s services and employer pricing.
Contact your UnitedHealthcare representative for details on Naviguard, program options, and next steps to get started.
Naviguard provides balance billing advocacy support to your employees with UnitedHealthcare benefits, while helping manage out-of-network costs for both your employees and the plan.
Health care professionals can confidently rely on Naviguard, a UnitedHealthcare out-of-network service, as a trusted advisor for resolving out-of-network balance bill disputes. Our team of industry experts, driven by data and equipped with extensive knowledge of national and local reimbursement rates, has successfully served over 7 million health plan members and more than 1,100 employers.
No, Naviguard is not a payer. Naviguard is a UnitedHealthcare service that uses expert negotiators to facilitate dispute resolution to effectively reduce out-of-network balance medical bills and quicker claim reprocessing.
Yes. Learn more at:
Claims, billing and payments | UHCprovider.com
If you’ve submitted a formal appeal, you’ll need to work directly with UnitedHealthcare for the appeal process. To obtain the status of the appeal, please contact the Naviguard Liaison assigned to your case, or use our Contact Us form.
For direct routing, call Naviguard at 952-246-0132 (Monday – Friday, 8 – 5 p.m. CT). Please leave a voice mail if you call outside of business hours.
The No Surprises Act (NSA) is a law that went into effect January 1, 2022, and has had major implications for patients, employers, health plans and providers.
Read more about the No Surprises Act.
Have a question for Naviguard or want to learn more about our services to help manage out-of-network health care costs? Don’t hesitate to reach out.
* Naviguard negotiates some, but not all, balance medical bills for out-of-network services. Keep in mind balance billing is when a provider bills a patient for the difference between the provider's charge and the amount allowed by the health plan.
