NaviClaim - FAQ Single Case Agreements

A Single Case Agreement (SCA) is a contract between a healthcare provider (such as a doctor or hospital) and a health benefits

company that is typically outside of the member's network. It allows the benefits company and provider to agree to cover a

specific cost threshold for a patient’s particular episode of treatment, even though the provider isn't part of their regular network.

SCAs are often used when a patient requires specialized care that isn't available within the network or when continuity of care is

essential (e.g., if the patient has already been receiving care from the out-of-network provider).

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

1. NaviClaim will gather the Provider’s name, the contact person at the facility (including their phone number, email and fax), as well as the Member’s name, ID number, and type of procedure.

2. NaviClaim will then send all of this information to FairPrice to begin the SCA process.

3. FairPrice will contact both the member and the provider within one business day of receiving the requests.

FairPrice is a negotiating company contracted by NaviClaim and Detego Health to help secure the best possible prices for our members' healthcare needs.

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 negotiated case by case between the out-of-network provider and the health benefits company. The success of the negotiation depends on how willing the provider and/or healthcare facility are to reach an agreement, and this process can take time. In some cases, an agreement may not be successful. When this happens, FairPrice will suggest alternative facilities where they have successfully negotiated before.

Call: 866-837-1436

Email: info@naviclaim.com

Fax: 855-613-4102

www.naviclaim.com