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Naviguard
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GUIDANCE FOR PATIENTS RESOLVING THEIR OUT-OF-NETWORK BILLING ISSUES

Naviguard is the trusted resource for answers to all your out-of-network billing
questions.




WHY NAVIGUARD


BETTER INFORMATION LEADS TO BETTER OUTCOMES.

That’s why we tailor our approach to reflect your situation. By fully
understanding the details of your personal story, we’re able to make the
strongest case possible when negotiating with your care provider.

Bringing clarity to your medical bill

Naviguard is on top of the latest healthcare rules and regulations, understands
provider networks, and has access to the most up-to-date health care pricing
resources. This means we know what providers should be charging you.

Negotiating from a position of strength

Benefit from working with a company that reaches successful bill resolutions
nearly 90% of the time. Our pricing data is based on real, local market rates,
our resources are widely respected, and our people bring decades of valuable
insight from across the health industry.

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HOW WE HELP PATIENTS


PROVIDING GUIDANCE ALONG THE WAY.

You’ll find flexible options to help resolve out-of-network medical bills — from
dedicated one-on-one assistance by a personal advisor to digital self-service
resources.

Naviguard services and resources can help you:

 * Understand your medical bill better.
 * Confirm if the service or provider was really out-of-network.
 * Verify there were no errors on your bill.
 * Better ensure you were charged appropriately and that the claim was processed
   correctly.
 * Negotiate and resolve your bill with your care provider.

Frequently Asked Questions
Members

Naviguard services are currently available to UnitedHealthcare members in
Naviguard participating health plans at no additional cost as part of your
employer benefits package. Ask your employer if you have Naviguard services.

Non-Members

If you are not a Naviguard member, our free introductory resources can help you
understand your out-of-network bill better, get organized, gather the necessary
paperwork, and build your case for negotiation and resolution.


GETTING STARTED


AS A MEMBER, HOW DO I GET STARTED?

1

CALL UNITEDHEALTHCARE MEMBER SERVICES

Call the number on the back of your UnitedHealthcare ID card to get started.

Have your out-of-network bill with you when you call.


2

CONNECT WITH A NAVIGUARD ADVISOR

Naviguard will reach out to you within 2 business days to discuss your options.


3

CREATE YOUR ACCOUNT

Track the progress of your case from start to finish through our online member
portal.


4

RECEIVE CASE SUMMARY

Once your case has been resolved, you will receive confirmation from your
Naviguard Advisor.

You can access your case anytime through the member portal to check the status.




REAL RESULTS


THE PROOF IS IN THE NUMBERS.

We put decades of health care experience to work for you. And it shows.

$2,200

Average balance bill reduction1

86%

Negotiation success rate2

72%

Average savings off billed charges3

64K+

Cases resolved4

View Sources

1Naviguard data January 2021 – May 2022. Average reduction is based on amount
claims negotiated to less than billed charges on claims where Naviguard was
engaged by the patient. Negotiation success rate may vary and is not a guarantee
of future results.

2Naviguard data January 2021 – April 2022. Based on Naviguard’s engagement with
its members during January 2021 through April 2022.  Negotiation success rate is
based on claims negotiated to less than billed charges. Negotiation success rate
may vary and is not a guarantee of future results.

3Naviguard data 1/1 – 7/31/2021. Discount on all out-of-network paid claims
(includes disputed claims and all other paid claims. Excludes denied claims.)
Savings results shown may vary based on customer plan and geographic
distribution and are not a guarantee of future results.

4Naviguard data January 2021 – May 2022. Resolved cases include all instances in
which a member contacted Naviguard and the case was reviewed and negotiated or
closed.


WHAT OUR CUSTOMERS SAY

> They were able to resolve my issue in a very favorable way. I just gave them
> the information and they did all the work.*

Lucas, New York

> This was such a blessing. My advisor explained everything and sent us the info
> we needed. She did all the work and kept us in the loop. Such a relief to know
> this has been taken care of, and I could put my focus on my husband’s health
> rather than fight with providers.*

Victoria, Arizona

> Thank you so much!! This is such a huge weight off my shoulders!*

Jennifer, Illinois

> I’ve never heard of this service until I had a large balance on an
> out-of-network ambulance bill. Somehow this bill was reduced by nearly $500.
> Thank you!! *

Caden, Arizona

> Definitely will recommend Naviguard, they were extremely helpful and took over
> the issue right away and fixed it. Thank you, thank you!!!!!!!!!!!!!!!!!*

Patricia, Arizona

> In addition to a favorable outcome, the overall customer experience was
> excellent. First, it was easy to get a representative on the phone without
> going through several annoying phone menus. The interactions via email were
> simple to use and very straightforward.*

Kimberli, South Carolina

> Very easy to work with and they reduced my medical bill significantly.*

Karl, Tennessee

> They were able to resolve my issue in a very favorable way. I just gave them
> the information and they did all the work.*

Lucas, New York

> This was such a blessing. My advisor explained everything and sent us the info
> we needed. She did all the work and kept us in the loop. Such a relief to know
> this has been taken care of, and I could put my focus on my husband’s health
> rather than fight with providers.*

Victoria, Arizona

> Thank you so much!! This is such a huge weight off my shoulders!*

Jennifer, Illinois

> I’ve never heard of this service until I had a large balance on an
> out-of-network ambulance bill. Somehow this bill was reduced by nearly $500.
> Thank you!! *

Caden, Arizona

> Definitely will recommend Naviguard, they were extremely helpful and took over
> the issue right away and fixed it. Thank you, thank you!!!!!!!!!!!!!!!!!*

Patricia, Arizona

> In addition to a favorable outcome, the overall customer experience was
> excellent. First, it was easy to get a representative on the phone without
> going through several annoying phone menus. The interactions via email were
> simple to use and very straightforward.*

Kimberli, South Carolina

> Very easy to work with and they reduced my medical bill significantly.*

Karl, Tennessee

> They were able to resolve my issue in a very favorable way. I just gave them
> the information and they did all the work.*

Lucas, New York

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NO SURPRISES ACT


HERE’S WHAT YOU NEED TO KNOW.

On January 1, 2022, the No Surprises Act (NSA) went into effect. Effective for
members when their health plan year commences in 2022, the NSA prohibits
surprise medical bills for patients like you for many — but not all —
out-of-network services, when the member cannot control where or who they
receive care from.

However, there are still situations when patients are not covered by the NSA.
That’s where Naviguard comes in.

What the NSA covers

Under the NSA, providers of certain types of services will not be allowed to
bill and pursue you directly for certain types of surprise medical bills.

These include emergency services (except ground ambulance), or when an
out-of-network provider is involved in your care while they are at an in-network
facility.

What the NSA does not cover

In general, if you choose to see a doctor or specialist who is not in-network,
the NSA and its protections will not apply, and you may face much higher costs
than your health plan’s in-network rate. The NSA does not protect patients from
balance billing for ground ambulance services, or when the law’s notice and
consent requirements are met.


OUR RESOURCES


RESOURCES TO GET YOU STARTED.

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

Dealing with Out of Network Bills with your ally Naviguard

Naviguard was created to help deal with unexpected, out-of-network medical
bills. Our goal is to provide clarity and to help reduce the costs of unexpected
and excessive out-of-network bills.

Learn More

Explanation of Benefits (EOB) Explained

It says, “This is not a bill.” So what exactly is an EOB, or Explanation of
Benefits. This article breaks down everything you need to know about your EOB.

Learn More

Overview of the No Surprises Act

On January 1, 2022, the No Surprises Act (NSA) went into effect, prohibiting
surprise medical bills for many — but not all — out-of-network services.
However, there are still situations when patients are not covered by the NSA –
and that’s where Naviguard comes in.

Learn More
See All Resources


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

*EXPERIENCES AND RESULTS FOR INDIVIDUALS WILL VARY. NAVIGUARD MAKES NO GUARANTY
THAT ANY INDIVIDUAL (OR ANY GROUP COLLECTIVELY) WILL ACHIEVE CERTAIN RESULTS.


Naviguard
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Naviguard is a member of the Nationwide Multistate Licensing System & Registry.
NMLS # 2051222
© 2022 Naviguard, Inc. Naviguard is a trademark of Naviguard, Inc.


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