Guidance for providers out-of-network billing resolution

Don’t let out-of-network billing conflicts keep you from getting paid
quickly.

IMG

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.

Valued partner icon
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.
 

 

 

icon
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.

Telegram icon
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. 

400K+

Cases resolved1

23 days

Average turnaround time for case resolution

9,000+

Providers engaged across 170+ specialties

  • 1Naviguard data January 2021 – December 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.

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’re here for you.

Have a question for Naviguard or want to learn more about our out-of-network medical bill services?

LET’S CONNECT
Update cookies preferences