FOR PROVIDERS

We help resolve out-of-network balance medical bills. Fast.

Naviguard®, a UnitedHealthcare out-of-network service, works with health care professionals to quickly resolve out-of-network billing issues. We focus on expedited claim reprocessing and resolution.

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WHY NAVIGUARD

Unresolved out-of-network billing conflicts can be costly

As a health care provider, you run the risk of unpaid out-of-network balance medical bills that hurt your bottom line. 

This may include:

  • Increased time in accounts receivable
  • Lower or lost payments
  • Administrative time spent chasing payments or accepting write-offs

NAVIGUARD CAN HELP

We want what you want: a fast resolution

Resolution support
Resolution support

On behalf of your patients and their health plans, Naviguard works with health care professionals to help quickly resolve out-of-network balance medical bills.

 

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Industry expertise

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. Our process is data-driven and objective.

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Easy process

Your involvement with Naviguard is designed to be easy and quick. We make it simple for health care professionals to engage in our process, saving you time and frustration. Our goal is a resolution that includes expedited claim reprocessing.

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Trusted advisor


Health care professionals can confidently rely on Naviguard to help quickly resolve out-of-network balance bill disputes. With a team of industry experts and a successful track record serving millions of health plan members, we are well positioned to help ensure optimal outcomes.

 

 
 

REAL RESULTS

Track record of success

By engaging with Naviguard, thousands of health care providers have expedited claim reprocessing. Our team of industry experts has successfully served over 7.2 million health plan members* and more than 1,100 employers.*

800K+

Cases resolved1

12,500+

Providers engaged across 160+ specialties

  • 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.

 

NO SURPRISES ACT

What you should know

Naviguard works to resolve out-of-network balance medical bills efficiently

The No Surprises Act (NSA) has had a large impact on health care professionals and facilities, including administrative process changes and additional requirements to follow. For health care providers, the NSA provides a process for resolving out-of-network payment disputes when federal law applies.

Naviguard works with providers on behalf of plans and members to resolve out-of-network billing claims quickly and efficiently. Our deep industry knowledge helps us understand the ins and outs of this law. Our expertise helps us achieve successful negotiations and avoid the hassle, cost and time of the independent dispute resolution process. Learn more about provider requirements and resources for the NSA.

Upcoming Changes

On January 1, 2022, the No Surprises Act (NSA) went into effect for health plan years commencing on or after that date. This has made a large impact on health care providers and facilities, including administrative process changes and additional requirements to follow.

For health care providers, the No Surprises Act provides a clear process for resolving out-of-network payment disputes. When the provider and the health plan can’t come to an agreement, a neutral third party will determine the payment for a service.

Engaging with Naviguard can help resolve bills efficiently

Naviguard works with health care providers on behalf of plans and patients to resolve out-of-network billing claims quickly and efficiently. Our deep industry knowledge means we understand the ins and outs of this new legislation from the point of view of providers, patients, employers, and insurers.

We believe in working cooperatively with providers to resolve out-of-network billing issues. Our expertise can help providers achieve successful negotiations and avoid the hassle, cost, and time of the independent dispute resolution process.

Upcoming Changes

On January 1, 2022, the No Surprises Act (NSA) went into effect for health plan years commencing on or after that date. This has made a large impact on health care providers and facilities, including administrative process changes and additional requirements to follow.

For health care providers, the No Surprises Act provides a clear process for resolving out-of-network payment disputes. When the provider and the health plan can’t come to an agreement, a neutral third party will determine the payment for a service.

 

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.

LET’S CONNECT
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