Highly Automated Enrollment Processing and Streamlined Reconciliation Speed Membership Growth, Reduce Costs and Maximize Revenue While Supporting Increased Compliance Conformance and Member Satisfaction
June 7, 2011--ikaSystems, a premier provider of enterprise-level cloud computing solutions for the healthcare payer market, and NASCO, an industry-leading provider of information technology solutions supporting the administrative efficiency of Blue Cross and Blue Shield Plans, have entered into an agreement that will bring faster, more efficient and accurate Medicare processes to NASCO Plan customers. As a result, NASCO Plan customers will dramatically reduce their administrative costs, maximize revenue, increase compliance conformance and achieve higher levels of member satisfaction through more efficient process management.
NASCO was formed in 1987 through a partnership among major Blues Plans. The company supplies a claims processing solution for national, state, large group, small group, individual and government programs; a highly configurable membership solution that can be tailored for any Plan's book of business; and many performance-based services to help plans improve operational efficiencies and reduce costs. NASCO's technology is built to handle large volumes and complex business, which is essential to its Plan customers.
"Partnering with ikaSystems was a natural fit for NASCO, as the company's solutions incorporate the same dependability, flexibility, scalability and operational performance for which NASCO has become well known," said John Ladaga, NASCO's chief executive officer. "In fact, NASCO and ikaSystems have many synergies that our Plan customers will benefit from, especially when it comes to reducing administrative and medical costs."
The first solution that NASCO will offer is ikaMedicareGateway, which delivers greater speed and accuracy to Medicare Advantage member enrollment and reconciliation processes for NASCO Plan customers. ikaMedicareGateway can be rapidly deployed, helping Plans to easily accommodate membership growth without the need to build large infrastructures. NASCO is using the following modules:
- The Enrollment Pathways Module reduces application processing time by as much as 80 percent through features such as real-time eligibility and entitlement queries, built-in Plan-specific/Centers for Medicare & Medicaid Services (CMS) Chapter 2 (Medicare Advantage Enrollment and Disenrollment Manual) validations, auto-population of enrollment screens and instantaneous feedback on application completeness. As a result, Plans substantially reduce rejection rates and rework.
- The Reconciliation Module automates, streamlines and integrates reconciliation processing. With daily, weekly and monthly reconciliation, Plans remain in compliance with CMS requirements and increase the accuracy of membership, enrollment and payment data. Fewer discrepancies combined with a more efficient process for discrepancy resolution greatly reduce the resources required to perform time-consuming research and duplicate effort.
"ikaSystems is always excited to partner with innovative organizations - whether they are health plans or other service providers - that share our passionate commitment to understanding the challenges facing the payer industry today and the best ways to turn those challenges into opportunities with the right technology," said Ravi Ika, chief executive officer of ikaSystems.
"NASCO has a well-established track record helping some of the nation's largest and most complex health plans realize significant operational efficiencies, reducing costs at every point in the administrative cycle, and the company's selection of ikaMedicareGateway is recognition of its unique capabilities to do the same with Medicare Advantage processes. We look forward to growing our partnership for the benefit of Blues plans," Ika concluded.
Horizon Blue Cross Blue Shield of New Jersey will be the first NASCO Plan customer to go live with ikaMedicareGateway, followed by the NASCO MembersEdge® enrollment system.