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?

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

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.

It’s happened to so many of us: you get a medical bill that throws you for a total loop. It’s for a provider or a service that’s defined as “out-of-network”—in other words, not covered by your health insurance.

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.

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.

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.

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

This guide breaks down some of the most common terms in healthcare billing. Look here for the full healthcare billing glossary from Naviguard.