The Navigation Team’s primary focus is supporting Members navigating complex care and pre-service negotiations for costly procedures. For example, care that includes more than one provider which requires separate self-pay estimates from the facility, physician, and anesthesiologist is when the Navigation Team is here to support your care journey.
Members are prompted to notify the Navigation Team when searching for complex and costly procedures in Healthcare Bluebook* available in the Member Center. For example, doctors often perform procedures in multiple locations, so we’ll help you navigate getting to a facility of high quality that offers a Fair Price*. We can also help you evaluate and secure a Good Faith Estimate for relevant procedures. The No Surprises Act protects patients from being billed more than $400 over the Good Faith Estimate.
When there is no identified Fair Price* provider for your service or there is no identified Fair Price* provider within 60 miles of your location, the Navigation Team will work with you to identify options. In this case, limitations may apply.
How do I get care if I can’t afford to pay for the service up front?
Members will be prompted to notify the Navigation Team when searching for complex and costly procedures using Healthcare Bluebook*. The search results will indicate if it is necessary to contact the Navigation Team before seeking care.
In the event of a medical emergency, you should seek care from their nearest hospital or doctor. Members should pay the minimum amount at the time of service, and ask to set up a payment plan. It is important to notify the Navigation Team after receiving emergency care so they can assist you if additional medical care is needed, or to help settle your medical bill with the provider.