NaviClaim - FAQ Single Case Agreements

 A Single Case Agreement (SCA) is a special contract between your health benefits company and a healthcare provider (like a doctor or hospital) who’s not normally in your network. This agreement lets both sides work out the costs for a specific treatment or care episode, so you can still get the care you need even if the provider isn’t in your usual network.

SCAs are helpful when you need specialized care that isn’t available within your network or when it’s crucial to continue seeing the same provider you’ve already been working with.

Providers, healthcare facilities, or members have to initiate all Single Case Agreements.

1. NaviClaim will collect all the important details — the provider’s name, a contact person at the facility (with their phone number, email, and fax), plus the member’s name, ID number, and the type of procedure.
 

2. Next, NaviClaim will send this information to FairPrice to get the SCA process started.
 

3. FairPrice will reach out to both the member and the provider within one business day of receiving the request.

 The company known as FairPrice collaborates with NaviClaim and Detego Health to ensure you receive the best possible prices for the care you need.  

A single-case agreement can take up to two weeks.

Please contact FairPrice for status updates by...

Phone: (866) 740-8399 or 

Email: members@yourfairprice.com for status updates.

No — these agreements are worked out on a case-by-case basis between the out-of-network provider and the health benefits company. Whether an agreement is finalized depends on how willing the provider or facility is to come to terms, and sometimes this process can take some time. In some situations, an agreement might not work out. If that happens, FairPrice will recommend other facilities where they’ve had success negotiating before, so you still have options. 

Call: 866-837-1436

Email: info@naviclaim.com

Fax: 855-613-4102

www.naviclaim.com