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Out-of-Network Medical Billing Resources

Use these resources to learn more about out-of-network medical bills, how to deal with them, and how to avoid them.

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The No Surprises Act for Patients

The No Surprises Act provides protections for patients who receive health care benefits from their employers or who are enrolled in individual health plans. For services that fall into these protected categories, providers will not be allowed to bill you for amounts higher than what you would pay from an in-network provider.

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The No Surprises Act for Employers

For employer-funded health plans, the NSA demands that significant requirements are met in provider/plan billing disputes. Check your health care plan for any restrictions on providers and other administrative particulars.

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The No Surprises Act for Providers

For healthcare 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.

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The Top Out-of-Network Risks

When it comes to your out-of-network health care, or services administered by a provider who is not contracted with your insurance company, the more you know, the better. Easier said than done, right?

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Medical Bills: Know the score. The credit score.

If having unpaid bills makes you feel uneasy, know that you’re not alone. What if the bill gets sent to a debt collection agency before you’ve had a chance to resolve it? Can an unpaid medical bill be reflected in your credit report? Will your credit score suffer if you don’t pay it? Here are a few words of advice.

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How to Negotiate a Medical Bill

How to Negotiate a Medical Bill with NaviguardWhen you receive a medical bill for an amount beyond your deductible, co-pay and co-insurance, it’s called a “balance bill.” Quite often, a balance bill is prompted by medical care that’s considered out-of-network, or services from a provider who doesn’t have a contract with your insurance company.

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Out-Of-Network Healthcare Deductibles, Copays, Coinsurance

Helping to understand Out-of-Network health care is what Naviguard does. We have broken down some confusing aspects including deductibles, copays, and coinsurance.

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What is Out-Of-Network Billing?

What is Out of Network Billing and how do you avoid it? Naviguard breaks down what OON bills are and what to do when you receive one.

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No Surprises Act Podcast

Michael Wentzien of Naviguard and Lisa McDonnel of UHC explain in this podcast the implementation and affect of the 2022 No Surprises Act legislation.

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