BillingNav provides healthcare payment integrity solutions for health plans, specializing in identifying and recovering improper payments related to No Surprises Act (NSA) compliance and balance billing issues. The platform helps insurers detect billing errors, enforce patient protections, and reduce claim leakage through automated review processes.
Funding
Funding not disclosed
Founders
Product
Problem
Health plans face significant financial losses from improper claim payments, particularly those involving balance billing practices and violations of the No Surprises Act. Identifying these errors manually is time-consuming and error-prone, leading to millions in overpayments and compliance risks.
Solution
BillingNav offers a specialized payment integrity platform that helps health plans detect and recover improper payments related to balance billing and No Surprises Act violations. The solution automates the review of claims to identify instances where providers billed patients or plans in ways that violate federal patient protection rules. By flagging these issues, BillingNav enables health plans to correct payments, pursue recoveries, and maintain regulatory compliance without straining internal resources.
Target Audience
Primary customers are health insurance plans, managed care organizations, and third-party administrators seeking to strengthen payment integrity and ensure No Surprises Act compliance.
Features
- Automated detection of balance billing violations and NSA non-compliance in claims data
- Claims review workflows designed specifically for health plan payment integrity teams
- Recovery support tools to help plans recoup overpayments from improper billing
- Compliance-focused analytics that track NSA-related billing patterns and risks