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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 out to the care navigation team 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.
Cash transactions are converted into standard 837 claim records and 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.
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.