Guidance for providers out-of-network billing resolution
Don’t let out-of-network billing conflicts keep you from getting paid quickly.
NAVIGUARD CAN HELP
Unresolved out-of-network billing conflicts can be costly
As a health care provider, you know you run the risk of unpaid out-of-network bills that hurt your bottom line.
This includes:
- Increased time in Accounts Receivable
- Lower or lost payments
- Administrative time spent chasing payments or accepting write-offs
Expertise that brings results
Don’t let out-of-network billing conflicts linger. By engaging with Naviguard on out-of-network bills, you can more quickly reach resolution and get clarity on OON bills, avoid arbitration, and expedite payments.
Quick, balanced payment resolution
Our objectively derived and market-based pricing model manages costs and mitigates risk. Not only does this help avoid arbitration, it also speeds up billing resolution, along with your payment. Because you deserve to be paid for the care you provide.
Reduced time stuck in accounts receivable
Providers deserve appropriate compensation for the services they provide, and the clarity necessary to support it.
By engaging with Naviguard, you can reach resolution faster, allowing you to be compensated quickly and appropriately for your services.
Industry expertise you can trust
Naviguard takes a market-based, reasonable, and data-driven approach to resolving out-of-network billing issues. As we work on behalf of the plan and the patient, we do so with compassion for all parties, a commitment to avoiding arbitration, and an interest in getting you paid quickly and appropriately.
Real Results
The proof is in the numbers
By engaging with Naviguard, thousands of health care providers like you have resolved their out-of-network billing disputes and received payment. Quickly.
260K+
Cases resolved1
23 days
Average turnaround time for case resolution
5,400+
Providers engaged across 173+ specialties
1Naviguard data January 2021 – April 2023. Resolved cases include all instances in which a member contacted Naviguard and the case was reviewed and negotiated or closed.
NO SURPRISES ACT
Here’s what you need to know
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.
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?