Skip to main content

Guidance for Patients Out-of-Network Billing Issues

Naviguard is the trusted resource for answers to all your out-of-network billing questions.

FAQ Header

Why Naviguard

Better information leads to better outcomes.

That’s why we tailor our approach to reflect your situation. By fully understanding the details of your personal story, we’re able to make the strongest case possible when negotiating with your care provider.

Bringing clarity to your medical bill

Naviguard is on top of the latest healthcare rules and regulations, understands provider networks, and has access to the most up-to-date health care pricing resources. This means we know what providers should be charging you.

Negotiating from a position of strength

Benefit from working with a company that reaches successful bill resolutions nearly 84% of the time. Our pricing data is based on real, local market rates, our resources are widely respected, and our people bring decades of valuable insight from across the health industry.

Getting started

As a member, how do I get started?

1

Call UnitedHealthcare Member Services

Call the number on the back of your UnitedHealthcare ID card to get started.

Have your out-of-network bill with you when you call.

Woman on the phone.
2

Connect with a Naviguard Advisor

Naviguard will reach out to you within 2 business days to discuss your options.

Provider liaison
3

Create Your Account

Track the progress of your case from start to finish through our online member portal.

Woman's hands typing on keyboard.
4

Receive Case Summary

Once your case has been resolved, you will receive confirmation from your Naviguard Advisor.

You can access your case anytime through the member portal to check the status.

Woman working on table by the window.

Real Results

The proof is in the numbers.

We put decades of health care experience to work for you. And it shows.

$2,372

Average balance bill reduction1

84%

Negotiation success rate2

77%

Average savings off billed charges3

87K+

Cases resolved4

1Naviguard data January 2021 – July 2022. Average reduction is based on amount claims negotiated to less than billed charges on claims where Naviguard was engaged by the patient. Negotiation success rate may vary and is not a guarantee of future results.

2Naviguard data January 2021 – July 2022. Based on Naviguard’s engagement with its members during January 2021 through April 2022.  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.

3Naviguard data 1/1/22 – 6/30/2022. 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.

4Naviguard data January 2021 – July 2022. Resolved cases include all instances in which a member contacted Naviguard and the case was reviewed and negotiated or closed.

What Our Customers Say

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

Thank you so much!! This is such a huge weight off my shoulders!*

Jennifer, Illinois

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

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

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

NO SURPRISES ACT

Here’s what you need to know.

On January 1, 2022, the No Surprises Act (NSA) went into effect. Effective for members when their health plan year commences in 2022, the NSA prohibits surprise medical bills for patients like you for many — but not all — out-of-network services, when the member cannot control where or who they receive care from.

However, there are still situations when patients are not covered by the NSA. That’s where Naviguard comes in.

NSA Does Cover
What the NSA covers

Under the NSA, providers of certain types of services will not be allowed to bill and pursue you directly for certain types of surprise medical bills.

These include emergency services (except ground ambulance), or when an out-of-network provider is involved in your care while they are at an in-network facility.

NSA Doesn’t Cover
What the NSA does not cover

In general, if you choose to see a doctor or specialist who is not in-network, the NSA and its protections will not apply, and you may face much higher costs than your health plan’s in-network rate. The NSA does not protect patients from balance billing for ground ambulance services, or when the law’s notice and consent requirements are met.

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?

LET’S CONNECT

*Experiences and results for individuals will vary. Naviguard makes no guaranty that any individual (or any group collectively) will achieve certain results.