Naviguard provides expert management of out-of-network medical billing by utilizing proprietary market-based pricing data to negotiate and resolve balance bills. This service alleviates the financial burden and confusion associated with unexpected out-of-network charges for both members and employers.
Funding
Funding not disclosed
Founders
Product
Problem
Out-of-network medical bills often lead to unexpected and inflated charges, causing financial stress and confusion for both patients and employers. Navigating the complexities of these bills and negotiating fair prices can be time-consuming and challenging. Many out-of-network claims are not covered by the No Surprises Act, leaving individuals vulnerable to significant costs.
Solution
Naviguard, a UnitedHealthcare service, provides expert management of out-of-network medical billing by leveraging market-based pricing data and negotiation strategies to resolve balance bills. The service aims to bring clarity to the complexities of out-of-network cost management, reducing frustration and reaching solutions that benefit members, employers, and providers. Naviguard's advisors offer personalized guidance to resolve billing issues, while their negotiation team engages directly with providers to agree on lower amounts. By understanding the details of each situation, Naviguard makes the strongest case possible when negotiating with care providers.
Target Audience
Naviguard's primary customers include individual health plan members and employers seeking to reduce out-of-network healthcare costs and alleviate the administrative burden associated with balance billing. The service also caters to healthcare providers looking for efficient resolution of out-of-network billing issues.
Features
- Expert negotiation of out-of-network balance medical bills, potentially reducing the amount owed
- Personalized guidance from Naviguard advisors, providing support throughout the resolution process
- Utilization of reference-based pricing, leveraging established and published rates to determine appropriate costs
- Secure online portal for members to upload bills and track case progress
- Management of details and interactions with providers, saving time and frustration for employers and members
- Robust client-level reporting for employers, providing insights into out-of-network spending
- Support for compliance with the No Surprises Act