Claims Adjudication & Benefits Management

We get it. You need to provide accurate and prompt benefit reimbursement to members no matter where they live, work or travel — and to providers, regardless of contractual arrangements or network configurations. The good news is that we’ve got you covered.

untitled-1_0006_layer-12

Leverage unparalleled performance.

NASCO’s claims product is a shared, best-in-class, high-performing, single-system solution. That means you can maximize your operational performance and capture significant administrative savings — it’s a win, win.

untitled-1_0005_layer-13

Know you can grow.

We process more than 20 percent of all Blue business. So, yeah, we can handle large volumes and complex business. Plus, our claims product is unsurpassed in the market for reliability, flexibility, scalability and operational efficiency, so you don’t ever have to worry about outgrowing our capabilities.

untitled-1_0004_layer-14

Implement new business with ease.

BeneFACTSM is NASCO’s suite of applications that supports group benefit product implementations. With BeneFACT, benefits are coded more quickly and with greater accuracy. As complex as benefits are these days, you need a solution that makes them as easy (and accurate) as 1-2-3.

untitled-1_0003_layer-15

Manage all of your business.

We efficiently process claims for all lines of business, including individual — both on and off exchange — small group, large group, national, premium, ASO, Medicare Advantage, Medicare Sup-plemental, FEP, dental and Taft-Hartley. If you’ve got it, we can process it.

untitled-1_0002_layer-16

Ensure security and compliance.

NASCO’s claims product and BeneFACT are both SOC2 Type II and HITRUST certified, so you can feel confident that your health plan and member data are secure.

untitled-1_0001_layer-17

Optimize your claims adjudication scores.

With Navigator for ClaimsSM, NASCO’s inventory management solution, you’ll be able to use intelligent workflows to streamline the processing, progression and operation¬al management of your pended claims inventory. This helps you ensure that the work gets into the right hands at the right time.

untitled-1_0000_layer-18

Maximize interoperability.

Integrating our solutions with your solutions is almost effortless. With NASCO’s Developer Portal, you gain access to a library of secure, open APIs and business events that can help transform your business and drive interoperability.

Still need more?

CLAIMS ADJUDICATION & BENEFITS MANAGEMENT-V2

BeneFACT case study

Ready to Empower the Future of Healthcare?

NASCO is continually innovating. We are developing new products, improving capabilities and increasing sharable services to ensure that our health plan customers remain competitive and are aligned with changing market demands.