Agents & Brokers
Learn how navces works for employers, agents, and brokers
Why Agents and Brokers want navces for their clients.
1. More businesses are moving to self-funded and level-funded health plans whereby they get money back for good claims experience.
2. Provide your clients with a better Healthcare experience.
3. With navces you gain a new competitive advantage in the market.
4. Bring real value to your clients with a measurable ROI.
5. Reduce the medical loss ratio.
6. Implement new strategies.
7. Get paid for helping your client.
Reduce Medical Waste and Improve Medical Efficiencies
navces is a Patient Advocacy Service created by Doctors to protect our members by exposing the truth about price and quality variation between medical providers. We find you, High-Value Medical Providers, at a Fair Price.
Intercept and Route Members to High-Value Medical Providers
All medical providers are not the same, and low-quality providers can be costly to both employees and the employer.
Hospitals do a lot of things…but they’re not great at everything, and a good hospital does not mean you get a great doctor.
A big-name hospital may be great at Neurosurgery but rank in the bottom percentile for Bariatric Surgery.
Our multiple data points and research measure Doctor Quality, Facility Quality, and Patient Savings. Individual rankings are by the procedure for 35 categories in addition to overall clinical performance. Hospital Quality Rankings are outcomes-based national rankings by procedure, and the patient savings rating is calculated by tracking specific referral patterns.
Reducing Medical Misdiagnosis Reduces Cost
Each year, an estimated 40,000 to 80,000 people die due to medical misdiagnosis that caused them to receive the wrong medical care or no care at all.
20% of patients with serious conditions are first misdiagnosed, and this is costly for both members and employers. In other areas such as spine surgery, this can be upwards of 67%.
12 million people—about 5% of adults who seek outpatient care—are misdiagnosed annually.
Identifying a medical misdiagnosis early can not only drastically reduce medical waste and cost but will, moreover, provide a better patient experience. Therefore, getting to the right doctor at the right facility the first time faster and easier is key to overall treatment success and overall total medical spending.
The Washington Post; Health & Science. Lenny Bernstein. 2017
Shop for Provider Quality and Cost of Care
For decades, HMOs and health insurance companies alike have been hiding the true cost of their contracted commercial rates between different medical providers, making shopping for healthcare not easy.
navces solves this problem by providing multiple product platforms that enable patients to understand price and quality before receiving medical care. Our navces Care Guidance Team does the research so you save hundreds, even thousands of dollars shopping quality and price on over 440 medical procedures.
We point you in the right direction to receive the best quality care. navces compares providers on cost and quality rankings. If an employee uses one of the navces recommended in-network High-Value Medical Providers, they can earn navces Incentive Rewards for being a smart healthcare consumer. If they choose to use another provider, they are not eligible to earn the rewards dollars and ultimately could end up with a low-quality medical provider and substandard medical care
Find the Best Price for Your Procedures
Price varies widely across your city.
Avoid overpaying for healthcare services.
With recent changes in legislation, navces offers transparency about the true cost of healthcare between medical providers.
Today, most major medical services, surgeries, and diagnostic tests are subject to deductible and coinsurance on major medical plans. So out-of-pocket costs for medical services can get expensive for members very quickly.
You would not buy a car without asking how much the car costs, so why would you treat shopping for your medical services any differently when over 440 services (or 23%) are shoppable?
Did you know there can be up to a 1605% difference in the cost for a medical service between providers within a 1-mile radius of each other, such as a colonoscopy?
When our members engage with navces before they seek medical service, the navces Care Guidance team will provide the member with several navces recommended in-network High-Quality Medical Providers at a Fair Price. This reduces costs for the employee and the employer.
Reward Members for Participating
The navces Incentive Rewards Program was created to encourage members to shop for healthcare services by rewarding plan participants when they make smart consumer choices by using cost-effective, high-quality medical providers. Members receive a check or check card because they or one of their dependents recently used one of our navces recommended in-network High-Value Medical Providers.
The cash incentive is used to engage and seek out those employees who may need medical services. Employees voluntarily enroll in our navces Care Guidance Program when referred for an eligible medical test (CT scan, MRI scan, PET scan, Ultrasound, etc.), procedure (Colonoscopy, EGD, etc.), surgery, or is an expecting mother.
As the Employer, you can choose to offer no rewards, Standard Rewards, or Engagement Rewards. The navces Engagement Rewards drive the highest participation and engagement in the program.
If the member follows the navces Care Guidance Team’s in-network recommendation for a diagnostic test center, medical treatment, procedure, or surgery upon a diagnosis, the member will be eligible to collect the navces Incentive Reward to offset the incurred medical expenses they are responsible for under the medical plan copay or deductible.
The Concept: navces Drives Lower Medical Loss Ratios (MLR)
25% of every dollar spent on healthcare is wasted. Patients do not know what kind of care they need, where to get it, or how much it’s going to cost.
Doctors typically do not have enough information on the patient to provide the most direct and cost-effective course of treatment—or even the correct initial diagnosis.
Employees have little experience in navigating the medical system and often find it difficult to access the right providers from the beginning. So we created navces (Navigation + Access) by Doctors for Employers and their Employees.
Most employers do not realize that 6 to 8% of employees are responsible for 80% of a company’s medical claims’ cost to insurance companies—or their companies directly if they are level-funded or self-insured.
By intercepting and engaging just these 6 to 8% of members and navigating them to the right care the first time using high-quality, high-value medical providers, employers can reduce cost, misdiagnosis, and medical errors, providing overall better healthcare experience for their employees.
Paying for Endless Medical Expenses: What Employers Should Know
The Affordable Care Act, formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, requires insurance companies to offer UNLIMITED major medical coverage.
In other words, the passage of this legislation has turned a medical ID card into essentially a credit card with an unlimited credit limit.
So, when you realize how costly medical treatment for an employee can become without the proper guidance or guardrails when they see low-quality, high-cost providers with bad outcomes, you will quickly see why navces makes so much sense for your company and your employees.
With 25% of every dollar that is spent on healthcare wasted, why would you not shop the over 440 procedures available through navces today? How should we be working together for you, your employees, and their families?
When a navces member chooses to participate, our navces Care Guidance Team will use multiple clinical data points to find the higher value, lower cost in-network providers to treat the condition or perform the surgery.
- Engage and redirect members to navces recommended High-Value Medical Providers for the best care at a Fair Price.
- Provide in-network Navigation and Access with guidance on complex procedures.
- Organize members’ medical histories and review what has been done.
- Connect members with top doctors using multiple data points.
- Create a plan.
- Prepare and coach members to get the most from their appointments with navces recommended High-Value Medical Providers.
- Measure the cost of services using commercial insurance claims data to make sure you are getting a Fair Price.
- Follow up with the patient and communicate until the treatment, procedure, or surgery has been completed.
- Navigate members through the healthcare system so they have access to the best care.
- For following our guidance and recommendations, members receive navces Incentive Rewards which can be used for medical expenses.
Right Provider + Right Facility = Lower Cost
The proven navces model provides medical cost savings for the employee and better medical outcomes. For the employer, navces provides large medical claims cost savings by avoiding low-value, high-cost providers for your employees. Over time, this presents a better medical loss ratio and overall lower healthcare cost for everyone.