How does navces work?

Frequently Asked Questions

Frequently Asked Questions

and our best possible answers

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 guide patients to make informed decisions when seeking medical care so they find you, navces recommended High-Value Medical Providers, at a Fair Price.

We provide easier access to navces recommended in-network High-Value Medical Providers—while saving you money on needed healthcare services. 

navces is a premium “concierge” service that helps ease the burden of finding navces recommended in-network High-Quality, High-Value Medical Providers at a Fair Price for an eligible medical test (CT scan, MRI scan, PET scan, Ultrasound, etc.), procedure (Colonoscopy, EGD, etc.), surgery, or if you are an expecting mother.

You may be eligible for navces Incentive Rewards for following our professional guidance.

No. navces is sponsored by your employer as part of your benefits program.

navces recommended High-Value Medical Provider includes any doctor, facility, or hospital that offers the highest value in terms of care quality, cost, and access.

We know that choosing the right medical provider for your healthcare needs is challenging. Furthermore, “shopping” for High-Quality at a Fair Price for healthcare is not easy. We see this problem every day and have solved it thousands of times for others.

navces solves this problem by providing a navces Patient Advocate-supported online platform that enables patients to understand price and quality before receiving care. Our trained navces Care Guidance Team uses national data scores and verified quality measurements to save hundreds, even thousands of dollars. 

We will point you in the right direction to receive the best quality care. navces will compare providers for you, on both cost and quality rankings. If you use one of the navces recommended High-Value Medical Providers, you can earn navces Incentive Rewards.

navces has over 440 shoppable medical procedures and the quality scores to recommend high-quality, cost-effective providers. 

For example…

Price variance of a Colonoscopy (screening) in Gainesville, FL

*Infographic Data Source Healthcare Bluebook

navces uses a proprietary analytics system to evaluate the allowed amounts (or discounted amounts) from medical claims and pricing in your geographic location and local market. This includes a variety of data sources to provide members with accurate Fair Price information for healthcare services individualized to their needs. This system is used to develop Fair Price data and provide High-Value quality rankings in markets nationally. navces can provide this service to all markets, all locations, and in all states.

navces provides price rankings instead of exact prices because, in some cases, additional services may need to be provided at the time of the appointment, changing the overall cost. 

A patient for example may expect to have an MRI scan without contrast. During the exam, it may be determined that contrast is needed for the MRI study. The actual MRI in this example, with contrast price, will be different from the MRI scan without contrast price. 

However, navces will guide you in choosing a navces recommended in-network High-Quality Medical Provider at a Fair Price so you do not overpay for your medical services.

navces uses multiple proprietary data points when determining quality rankings.

While hospitals can perform many different procedures, most hospitals do not have the same level of quality in every clinical area. 

Hospital quality rankings are designed to help patients understand each hospital’s overall level of quality for a particular inpatient clinical area or procedure. Similarly, our physician rankings are designed to help patients understand a physician’s overall quality, as well as the physician’s outcomes for specific procedures. Each hospital is compared against all other US hospitals and each physician against other physicians. Note that most diagnostic testing is not measurable for quality.

navces quality rankings are built upon the same patient outcomes-based framework as the hospital quality rankings. We offer both overall and procedure-specific physician rankings when available.

Physician quality ranking is calculated with multiple data points by evaluating each physician’s patient-specific outcomes in a clinical area. The ranking is calculated by combining a physician’s performance in several areas: patient complications, patient safety, mortality, and unplanned re-admissions. All metrics are risk and volume adjusted. Calculations are based on a statistically significant sample drawn from CMS data. Our methodology is validated and published in peer-reviewed medical journals.

No, very few hospitals are good at all things. 

Other quality metrics you will see only use a single overall ranking for each hospital. That does not work effectively in the patient’s best interest. That approach is not helpful to members because a single ranking can mask important differences in the level of quality between clinical areas at the hospital. 

For example, a hospital can be among the highest performing facilities in the US for heart surgery, yet the same hospital can also be among the poorest performing facilities for joint replacement. If you are a patient in need of a knee replacement, you must have the ability to assess the hospital’s performance specifically for the care you need, as opposed to an overall hospital score across all clinical areas. navces uses multiple comprehensive data points in its research for quality rankings.

navces uses multiple data points for quality rankings, including hospital and physician quality rankings data from CMS, all-payer databases and the Agency for Healthcare Research and Quality (AHRQ), and Healthcare Bluebook. We also use independent research performed by our navces Care Guidance Team, which is composed of licensed and practicing Physicians, Registered Nurses, and Patient Advocates.

The quality rankings highlight which hospitals and/or physicians have historically demonstrated better patient outcomes for a particular service. The quality score is a reliability score relative to other hospitals/physicians in the US—however, it is not a guarantee.

You can save hundreds, even thousands of dollars on medical procedures and earn up to $1,500 in navces Incentive Rewards with the navces Incentive Rewards Program.

navces has been selected by your employer and is typically accompanied by the navces Incentive Rewards Program as an added benefit to help you with the cost of healthcare services. 

The navces Incentive Rewards Program was created to encourage healthcare consumerism by rewarding plan participants when they make good consumer choices by using cost-effective, high-quality providers. 

You could receive a check because you or one of your dependents recently used a navces recommended in-network High-Value Medical Provider.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call 1-(833) 4-navces (462-8237) or email rewards@navces.com.

Yes, all eligibility documents for navces Incentive Rewards must be submitted within sixty (60) days from the date of service to be eligible for the rewards.

You may be eligible if you are referred by a Medical Doctor for: 

  1. Any medical service subject to your major medical deductible, including pregnancy 
  2. A major diagnostic service such as CT scan, MRI scan, PET scan, Ultrasound, etc. 
  3. Are referred for an outpatient procedure such as a Colonoscopy, EGD, etc.
  4. Are diagnosed and referred for treatment with inpatient or outpatient surgery

Eligible participating health plan members may be entitled to up to $1500 in navces Incentive Rewards for using a navces recommended High-Value Medical Provider.

navces Incentive Rewards are mailed to your home address and will be addressed to the employee, regardless of which family member received care.

Yes. You may receive multiple navces Incentive Rewards for procedures rendered on the same day. For example, a patient may need a Knee MRI scan and a Hip MRI scan on the same day. In this case, the patient would receive a separate reward for using navces recommended High-Value Medical Providers for both of the separate services.

You or a family member must be a current employee with active health insurance coverage at the time of navces Incentive Rewards processing to receive the reward. Your employer reserves the right to modify or discontinue the navces Incentive Rewards Program at any time.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

Step 1. Go to www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com. 

Step 2. Your navces Patient Advocate will contact you to confirm what test or procedure is needed and open a navces Care Guidance Ticket.

Step 3. Your navces Patient Advocate will find you navces recommended in-network High-Value Medical Providers focused on quality and cost.

Step 4. You can choose any one of the navces recommended in-network High-Value Medical Providers.*

Step 5. Once completed, members will send (1) their Insurance Explanation of Benefits (EOB) and (2) the Bill from the Provider, Doctor, Facility, and/or Hospital to us at rewards@navces.com. You can also fax it to us at (786) 471-1078.  

Note: All navces Incentive Rewards supporting documents must be submitted to navces within sixty (60) days from the date of service to be eligible.

*Members may choose any provider they wish but must use a navces recommended in-network High-Value Medical Provider to be eligible for the navces Incentive Rewards Program.

If you have any questions about the navces Incentive Rewards Program, please contact your HR Department, go to www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

 

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 guide patients to make informed decisions when seeking medical care so they find you, navces recommended High-Value Medical Providers, at a Fair Price.

We provide easier access to navces recommended in-network High-Value Medical Providers—while saving you money on needed healthcare services. 

navces is a premium “concierge” service that helps ease the burden of finding navces recommended in-network High-Quality, High-Value Medical Providers at a Fair Price for an eligible medical test (CT scan, MRI scan, PET scan, Ultrasound, etc.), procedure (Colonoscopy, EGD, etc.), surgery, or if you are an expecting mother.

You may be eligible for navces Incentive Rewards for following our professional guidance.

Based on best practices, listed below are just a few of the over 440 navces procedure categories and dollar amounts for the navces Incentive Rewards Program for shoppable procedures. 

Most diagnostic medical tests, procedures, treatments, and surgery are rewarded and eligible if using navces recommended in-network High-Value Medical Providers.

The employee, spouse, or dependent that receives an eligible service is eligible to earn a navces Incentive Reward through this program.

navces handles fulfillment when the member submits (1) their Insurance Explanation of Benefits (EOB) and or (2) the Bill from the Provider, Doctor, Facility, and/or Hospital as proof they were treated a Go Green or Yellow lever Healthcare Bluebook provide or a recommended provider listed in your navces  High-Value Providers Report you revived from the Care Guidance team.

Members must send all the provider documents to rewards@navces.com or to their assigned navces Care Guidance Patient Advocate. The documents are reviewed for eligibility, and then navces Incentive Rewards are issued to qualifying members.

navces does not offer tax advice but encourages clients to consult with their tax advisors and confirm the most appropriate rewards tax treatment for their organization. navces may support clients, regardless of the tax decision.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call 1-(833) 4-navces (462-8237) or email rewards@navces.com.

navces Incentive Reward checks are sent along with a congratulatory letter. For dependents under age 18, the information is sent to the employee. The congratulatory letter includes ideas and steps encouraging positive behavior in handling your health for the future.

No, your employer is responsible for the costs of the navces Incentive Rewards. There are no additional administration fees from navcesnavces Incentive Rewards are paid by navces in our agreement with your employer.

Yes, all eligibility documents for navces Incentive Rewards must be submitted within sixty (60) days from the date of service to be eligible for the rewards.

navces Incentive Rewards are mailed to your home address and will be addressed to the employee, regardless of which family member received care.

Yes. You may receive multiple navces Incentive Rewards for procedures rendered on the same day. For example, a patient may need a Knee MRI scan and a Hip MRI scan on the same day. In this case, the patient would receive a separate reward for using navces recommended High-Value Medical Providers for both of the separate services.

You or a family member must be a current employee with active health insurance coverage at the time of navces Incentive Reward processing to receive the reward. Your employer reserves the right to modify or discontinue the navces Incentive Rewards Program at any time.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

Step 1. Go to www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com. 

Step 2. Your navces Patient Advocate will contact you to confirm what test or procedure is needed and open a navces Care Guidance Ticket.

Step 3. Your navces Patient Advocate will find you navces recommended in-network High-Value Medical Providers focused on quality and cost.

Step 4. You can choose any one of the navces recommended in-network High-Value Medical Providers.*

Step 5. Once completed, members will send (1) their Insurance Explanation of Benefits (EOB) and (2) the Bill from the Provider, Doctor, Facility, and/or Hospital to us at rewards@navces.com. You can also fax it to us at (786) 471-1078.  

Note: All navces Incentive Rewards supporting documents must be submitted to navces within sixty (60) days from the date of service to be eligible.

*Members may choose any provider they wish but must use a navces recommended in-network High-Value Medical Provider to be eligible for the navces Incentive Rewards Program.

If you have any questions about the navces Incentive Rewards Program, please contact your HR Department, go to www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

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 guide patients to make informed decisions when seeking medical care so they find you, navces recommended High-Value Medical Providers, at a Fair Price.

Yes, when following our “Best Practices,” employers can see an ROI of 4:1 with just 20 percent utilization and a 10:1 return on navces Incentive Spend. In combination with our data partners, navces has identified 1,500 common medical procedures (90 percent of employers group medical spend) that present the deepest savings opportunities when using navces recommended High-Value Medical Providers. Employee members save when accessing High-Value, Fair-Priced medical service under the health plan deductible and out-of-pocket maximum.

We use multiple data points to navigate and provide easier access to navces recommended in-network High-Value Medical Providers at a Fair Price—while saving members money on needed healthcare services.

navces is a premium “concierge” service that helps ease the burden of finding navces recommended in-network High-Quality, High-Value Medical Providers at a Fair Price for an eligible medical test (CT scan, MRI scan, PET scan, Ultrasound, etc.), procedure (Colonoscopy, EGD, etc.), surgery, or if you are an expecting mother.

Employee members may be eligible for monetary rewards that can be used towards medical expenses for following our professional guidance.

All Pricing is derived by analyzing commercial claims data. Prices are based on allowed amounts paid by commercial insurance carriers based on their negotiated in-network rates.

Quality data is harvested with multiple data points and independent clinical research. Data Sources include the CMS Standard Analytic File—three years of data scores calculated directly from claims data, risk, and volume, adjusted with additional metrics.

Hospital quality rankings are based on national rankings by the medical test, procedure, or surgery. These rankings are listed from 0–100% for all US hospitals.

Patient savings ratings track doctor-specific referral patterns.

Based on best practices, listed below are just a few of the over 440 navces procedure categories and dollar amounts for the navces Incentive Rewards Program for shoppable procedures. 

Most diagnostic medical tests, procedures, treatments, and surgeries are rewarded and eligible if using navces recommended in-network High-Value Medical Providers.

The employee, spouse, or dependent that receives an eligible service is eligible to earn a navces Incentive Reward through this program.

Yes, because every employer and insurance program is different. We have customized navces Incentive Rewards Programs for Self-Funded, Level-Funded, and those employers that are fully insured based on our “Best Practices.” The programs available are as follows:

  1. Standard Rewards (the lowest monetary reward level, mostly for Fully Insured plans)
  2. Engagement Rewards (the highest incentive monetary reward level)
  3. Customized Rewards (HRA or by shoppable procedures; targets specific risk management) 
  4. No Rewards

navces handles fulfillment when the member submits (1) their Insurance Explanation of Benefits (EOB) and or (2) the Bill from the Provider, Doctor, Facility, and/or Hospital as proof they were treated a Go Green or Yellow lever Healthcare Bluebook provide or a recommended provider listed in your navces  High-Value Providers Report you revived from the Care Guidance team.

Members must send all the provider documents to rewards@navces.com or to their assigned navces Care Guidance Patient Advocate. The documents are reviewed for eligibility, and then navces Incentive Rewards are issued to qualifying members.

navces does not offer tax advice but encourages clients to consult with their tax advisors and confirm the most appropriate rewards tax treatment for their organization. navces may support clients, regardless of the tax decision.

The employee MUST contact navces before they seek testing or treatment or use the navces shoppable procedures app to identify the provider in advance of the medical treatment, test, or surgery. They must call 1-(833) 4-navces (462-8237), email rewards@navces.com, or contact one of our navces Care Guidance Patient Advocates.

navces Incentive Reward checks are sent along with a congratulatory letter. For dependents under age 18, the information is sent to the employee. The congratulatory letter includes ideas and steps encouraging positive behavior in handling your health for the future.

Yes, the employer is responsible for the costs of the navces Incentive Rewards the employee receives. The rewards cost is billed on a monthly basis to the employer or is drawn against the established rewards retainer deposited at the start of the navces Incentive Rewards Program.

Yes, all eligibility documents for navces Incentive Rewards must be submitted within sixty (60) days from the date of service to be eligible for the rewards.

navces handles all navces Incentive Rewards fulfillment. We mail it to the home address of the member with a congratulatory letter rewarding them for using a navces recommended High-Value Medical Provider. Checks or Check cards will be addressed to the employee, regardless of which family member received care.

Yes. Employee members can receive multiple navces Incentive Rewards for procedures rendered on the same day. For example, a patient may need a Knee MRI scan and a Hip MRI scan on the same day. In this case, the patient would receive a separate reward for using navces recommended High-Value Medical Providers for both of the separate services.

It’s a fact that navces Incentive Rewards increase utilization. When members are rewarded for using navces to shop for, schedule, and receive care from a navces recommended High-Value “Green” Medical Providers, utilization and related savings are quantified through clear attribution between provider searches and completed procedures.

navces is a one-stop-shop for access to engagement materials for distribution to your employees. We also provide year-round engagement through postcards, optimized email and text campaigns to members, and the administration of the reward as a monetary incentive as well as participation in raffle prizes.

The member must be a current employee or active under COBRA Health Insurance coverage at the time of navces Incentive Rewards processing to receive the reward. You as the employer reserve the right to modify or discontinue the navces Incentive Rewards Program at any time.

No, employees under the health plan can use any provider of their choice. However, to be eligible for navces Incentive Rewards, they must see a navces recommended High-Value Medical Provider recognized by the navces Care Guidance Team or in the HCBB App. navces is not a substitute for a medical provider. navces provider recommendations are based on CMS and MIPS Scores for Quality Rankings in combination with the fairest prices. Employee members can and should retain their own personal physician, therapist, and medical professional for purposes of obtaining such medical, therapeutic, or surgical advice if and when it is needed and appropriate.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

Step 1. Go to www.navces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com. 

Step 2. Your navces Patient Advocate will contact you to confirm what test or procedure is needed and open a navces Care Guidance Ticket.

Step 3. Your navces Patient Advocate will find you navces recommended in-network High-Value Medical Providers focused on quality and cost.

Step 4. You can choose any one of the navces recommended in-network High-Value Medical Providers.*

Step 5. Once completed, members will send (1) their Insurance Explanation of Benefits (EOB) and (2) the Bill from the Provider, Doctor, Facility, and/or Hospital to us at rewards@navces.com. You can also fax it to us at (786) 471-1078.  

Note: All navces Incentive Rewards supporting documents must be submitted to navces within sixty (60) days from the date of service to be eligible.

*Members may choose any provider they wish but must use a navces recommended in-network High-Value Medical Provider to be eligible for the navces Incentive Rewards Program.

If you have any questions about the navces Incentive Rewards Program, please contact us at www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email info@navces.com.

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 guide patients to make informed decisions when seeking medical care so they find you, navces recommended High-Value Medical Providers, at a Fair Price.

We provide easier access to navces recommended in-network High-Value Medical Providers—while saving you money on needed healthcare services. 

navces is a premium “concierge” service that helps ease the burden of finding navces recommended in-network High-Quality, High-Value Medical Providers at a Fair Price for an eligible medical test (CT scan, MRI scan, PET scan, Ultrasound, etc.), procedure (Colonoscopy, EGD, etc.), surgery, or if you are an expecting mother.

You may be eligible for navces Incentive Rewards for following our professional guidance.

Based on best practices, listed below are just a few of the over 440 navces procedure categories and dollar amounts for the navces Incentive Rewards Program for shoppable procedures. 

Most diagnostic medical tests, procedures, treatments, and surgery are rewarded and eligible if using navces recommended in-network High-Value Medical Providers.

The employee, spouse, or dependent that receives an eligible service is eligible to earn a navces Incentive Reward through this program.

navces handles fulfillment when the member submits (1) their Insurance Explanation of Benefits (EOB) and or (2) the Bill from the Provider, Doctor, Facility, and/or Hospital as proof they were treated a Go Green or Yellow lever Healthcare Bluebook provide or a recommended provider listed in your navces  High-Value Providers Report you revived from the Care Guidance team.

Members must send all the provider documents to rewards@navces.com or to their assigned navces Care Guidance Patient Advocate. The documents are reviewed for eligibility, and then navces Incentive Rewards are issued to qualifying members.

navces does not offer tax advice but encourages clients to consult with their tax advisors and confirm the most appropriate rewards tax treatment for their organization. navces may support clients, regardless of the tax decision.n.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call 1-(833) 4-navces (462-8237) or email rewards@navces.com.

navces Incentive Reward checks are sent along with a congratulatory letter. For dependents under age 18, the information is sent to the employee. The congratulatory letter includes ideas and steps encouraging positive behavior in handling your health for the future.

No, your employer is responsible for the costs of the navces Incentive Rewards. There are no additional administration fees from navcesnavces Incentive Rewards are paid by navces in our agreement with your employer.

Yes, all eligibility documents for navces Incentive Rewards must be submitted within sixty (60) days from the date of service to be eligible for the rewards.

navces Incentive Rewards are mailed to your home address and will be addressed to the employee, regardless of which family member received care.

Yes. You may receive multiple navces Incentive Rewards for procedures rendered on the same day. For example, a patient may need a Knee MRI scan and a Hip MRI scan on the same day. In this case, the patient would receive a separate reward for using navces recommended High-Value Medical Providers for both of the separate services.

You or a family member must be a current employee with active health insurance coverage at the time of navces Incentive Reward processing to receive the reward. Your employer reserves the right to modify or discontinue the navces Incentive Rewards Program at any time.

To see if you are eligible, you MUST contact navces before you seek testing or treatment. You can call (833) 4-navces or (833) 462-8237, or email rewards@navces.com.

Step 1. Go to www.mynavces.com, call (833) 4-navces or (833) 462-8237, or email rewards@navces.com. 

Step 2. Your navces Patient Advocate will contact you to confirm what test or procedure is needed and open a navces Care Guidance Ticket.

Step 3. Your navces Patient Advocate will find you navces recommended in-network High-Value Medical Providers focused on quality and cost.

Step 4. You can choose any one of the navces recommended in-network High-Value Medical Providers.*

Step 5. Once completed, members will send (1) their Insurance Explanation of Benefits (EOB) and (2) the Bill from the Provider, Doctor, Facility, and/or Hospital to us at rewards@navces.com. You can also fax it to us at (786) 471-1078.  

Note: All navces Incentive Rewards supporting documents must be submitted to navces within sixty (60) days from the date of service to be eligible.

*Members may choose any provider they wish but must use a navces recommended in-network High-Value Medical Provider to be eligible for the navces Incentive Rewards Program.

If you have any questions about the navces Incentive Rewards Program, please contact your HR Department, go to www.mynavces.com, call (833) 4-navces or (833) 462-8237 or email rewards@navces.com.