WHY NAVIGUARD
We excel in negotiating and settling balance medical bills
Naviguard works with employers in all industries to help them avoid overpaying for out-of-network services. In addition, we offer valuable insights into employees' utilization of out-of-network providers and ensure a straightforward and hassle-free experience for your employees.
The Naviguard out-of-network program is built to keep excessive out-of-network charges in check for members and offers the following benefits:
Benefits for employers:
- Naviguard manages the details and provider interactions saving employers time and frustration
- Robust client-level reporting
- Increased employee satisfaction
- No Surprises Act support
Benefits for members:
- Tailored negotiation approach for certain services
- Personalized and simple consumer experience
- Advocacy for members via dedicated 1-on-1 relationships
- Secure online member portal offering support and tools
- No Surprises Act support
OUR STRENGTHS AND SOLUTIONS
Count on the experts
Managing out-of-network benefits and independent dispute resolution processes can be complex and demanding. But you don’t have to do it alone.
Guidance and support
Faced with responsibilities for managing out-of-network costs, you need an expert who understands all the complexities of the out-of-network landscape and can relieve your administrative burden. Naviguard is that expert.
Industry expertise
Naviguard includes a premier out-of-network balance medical billing team of experts with decades of health care experience, plus access to one of the most robust provider networks in the industry. We are uniquely positioned to lower out-of-network costs and simplify the health care experience for everyone.
Trusted expert
Naviguard is a reliable ally that works with employers and their health plan members to resolve out-of-network balance medical bills. We engage and negotiate with health care professionals to resolve those bills, helping make health care more affordable for both employees and employers.
Unique approach
Our experts manage the details and provider interactions, saving you time and frustration. What’s more, we provide flexible service options for you and your employees.
National and local market experience
We leverage referenced-based pricing that includes the use of established and published rates and reimbursement methodologies to determine the appropriate rate for medical services.
We put decades of health care experience to work for you. And it shows.
REAL RESULTS
Track record of success
Naviguard works with employers in all industries and sizes across the U.S. to help them avoid overpaying for out-of-network services. And it shows.
$11B+
Value delivered to our employer clients to date
800K+
Cases resolved1
77%
Average value off billed charges2
71
Net Promoter Score3
99%
Client retention rate
$2,200
Average reduction per bill
-
1Naviguard data January 2021 – August 2024. Resolved cases include all instances in which a member contacted Naviguard and the case was reviewed and negotiated or closed.
2Naviguard data January 2021 – August 2024. Discount on all out-of-network paid claims (includes disputed claims and all other paid claims. Excludes denied claims.) Savings results shown may vary based on customer plan and geographic distribution and are not a guarantee of future results.
3Based on Naviguard’s engagement with its members during January 2021 – August 2024. 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.
How we help your employees
Check the Explanation of Benefits
If an employee receives care from an out-of-network provider, they should pay close attention to the Explanation of Benefits (EOB) they get from UnitedHealthcare. If the amount they owe is higher than their cost share, they may receive a balance medical bill. They are encouraged to talk with a Naviguard Advisor before paying their bill to explore their options.
Activate the Naviguard benefit
If the employee receives a balance medical bill from their provider, they should call the number on the health plan ID card to active the Naviguard benefit. Naviguard will send the employee an email with simple instructions to create a secure online account. The advisor is available to answer any questions the employee may have at any stage of the process.
Case review
After the employee provides all the necessary information, a dedicated advisor will review the employee's case with the negotiation team and provide updates on possible next steps. Once negotiation has started, the advisor will keep the employee updated on the status of the case with information from the negotiator.
Review the results
On average, the negotiation process takes about 30–45 days, depending on how responsive the provider is. As soon as the case has been resolved, the advisor will contact the employee with details of the outcome and guidance on what to do next.
OUR RESOURCES
Resources to get you started
Naviguard offers many resources to help you learn how you can support and empower your employees to reduce their out-of-network health care costs.
Here are just a few.
Behavioral health hurdles
Behavioral health care is in demand, and some employees are going out-of-network to get the services they need. Learn what many employers are doing to support their employees — and in the process retain them, enhance productivity and remain competitive. It’s a win/win for employers and employees.
CONTACT US
We can help
Have a question for Naviguard or want to learn more about our out-of-network medical bill services? Don’t hesitate to reach out.