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A PPO plan with a built-in $0 option. When cash pricing is lower, members pay nothing. If not, they use their PPO like normal.
Members don't have to guess which option is better.
We show them both — and guide them to the lower-cost choice.
Steering members to transparent cash pricing routinely outperforms negotiated network rates — especially on imaging, labs, and routine procedures.
Same network, same providers, same ID card. The PPO is always there as a fallback. No member is forced to use cash pricing — it's simply available when it makes sense.
Care navigation, funding, and plan administration coordinated under one roof. One integrated experience for your members, not a bolted-on carve-out.
Reach the care navigation team by phone or text message when you need care, or when pre-authorization is required. We'll explain your options.
Navigators research transparent cash pricing in your area and present alternatives side by side — cash option, PPO option, or both.
When cash pricing is meaningfully better (about 15%+ below PPO rates), the $0 option becomes available. Otherwise, your PPO benefits work as usual.
If you choose the cash option, funds are loaded onto your RightRoute Pay debit card. Hand it to the provider — that's it.
Independent imaging centers often price significantly below hospital-based PPO rates for the same scan.
Direct-to-consumer lab pricing is frequently a fraction of in-network billed rates.
Colonoscopies, sleep studies, and other shoppable procedures regularly come in below network-negotiated rates.
In most cash-pay arrangements, the plan goes blind: no claim is filed, so nothing credits the deductible, accumulators never update, and the visit vanishes from claims data and stop-loss reporting.
Every RightRoute Pay transaction generates a standard 837 claim record delivered back to the plan — deductibles and accumulators stay current, and reporting stays complete.
The plan's data reads as if the claim had traveled the normal pipe — just at the lower cash price. No side ledger, no manual reconciliation, no blind spots.
No. The plan keeps full PPO network access — the cash option is added on top. Members get more flexibility, not less.
No. The same hospitals and physicians often offer both insurance and cash pricing. Navigation identifies high-quality providers offering competitive rates.
No. Members can always choose to use their PPO benefits instead. RightRoute Pay guides toward the lower-cost option, but the PPO is always available.
Emergency services process under the PPO benefits as usual. Members should never delay emergency care to call navigation.
Yes. On HSA-qualified high-deductible plans, the deductible must be met first. Once met, members can use RightRoute Pay without drawing on HSA funds.
Either works. Members can call or text the care navigation team — the number is in their plan materials. Standard message and data rates may apply for texting.
If a member uses their insurance card or pays out-of-pocket without going through navigation, the plan can't retroactively apply RightRoute Pay pricing.
Care navigation, funding, and plan
administration — under one roof.
We coordinate the entire experience — so brokers, employers, and members have a single point of contact from the first call to the paid visit.
Members, brokers, and HR teams — send a question about how RightRoute Pay works and we'll get back to you.
We've opened a pre-filled email to our team in your mail app. Send it and we'll get back to you shortly. If nothing opened, your question is still in the form above — copy it and email help@rightroutepay.com, or call (866) 991-4900.