ADVANCING TECHNOLOGY FOR

FEDERAL HEALTH AGENCIES

We helped build Medicare into the program it is today and have been with CMS through its every evolution. We are trusted to solve agencies’ complex IT challenges with agile solutions that provide necessary infrastructure, functionality, scalability and security.

Federal health care relies on powerful IT solutions to ensure all back-end processes run smoothly. National Government Services knows seamless data integration among various systems is key. As a trusted partner helping federal agencies with IT modernization, COTS application implementation and more, we are truly shaping health care for today and beyond.

Our areas of expertise include:

  • Systems integration
  • Claims systems
  • Electronic Data Interchange
  • Case management systems
  • Electronic health records systems
  • Data management
  • Customer relationship management
  • Security

Applying the latest technology

For more than 50 years, federal agencies have trusted us to construct custom IT solutions. Whether it’s programs to help root out fraud, waste and abuse or systems to increase the accuracy of provider payments, National Government Services has risen to the challenge. By staying on the leading edge of IT advances, we build solutions that integrate the most current technological capabilities.

Systems integration

We bring increased functionality, drive data transparency and bridge the divide between health providers and beneficiaries receiving care. We help agencies with:

  • Custom client web portals
  • Federal health care systems expertise
  • Integrating and customizing large Oracle-Siebel environments
  • Compliant and secure data management
  • Self-service interactive voice response systems
  • Vendor-agnostic solutions

Claims systems

Claims systems can contain many nuances only a true expert understands. With a five-decade track record, federal agencies look to the models we helped establish to act as a footprint for their current health care operations.

With CMS’ technology, we process 230 million claims a year, which is more than 20 percent of Medicare’s total claims workload. Never settling for good enough, our team develops ways to continually streamline workloads and improve current techniques.

We’ve earned our stripes as a leading claims processor by:

  • Automating redundant functions
  • Implementing structure file editing
  • Integrating case management solutions
  • Working with 370,000 providers and health care organizations who file HIPAA-compliant EDI claims

Electronic Data Interchange (EDI)

Our EDI solutions provide customers with many value-adds, such as the inclusion of an edit module that is integrated in our front-end system to eliminate the need for crosswalks and manual transactions.

We have experience working with clearinghouses, trading partners and other claim entities across the country to receive and process transactions. With system uptime of greater than 99 percent, agencies can rest assured that National Government Services’ EDI is working hard for them.

Case management systems

We hold the key to a dynamic case management solution that improves production times and quality throughout a case’s entire lifecycle. Our automated process escalates and prioritizes tasks while balancing workloads and reducing customer inquiry response time.

Our fully scalable case management systems offer task visibility, advanced data tracking and robust workflow capability.

Electronic health records (EHR) system

With the complexity of health care records today, smart use of technology is the path forward for federal agencies looking to provide a higher level of care to the populations they serve. Solutions from National Government Services are driving the integration and adoption of electronic health records that leads to better quality of care for millions of beneficiaries.

Data hosting

National Government Services’ data center provides hosting for key programs:

We offer system software support, hardware support, computer operations and production control, and data recovery services. Our hosted data makes it possible for 20,000 customer service representatives to serve more than 60 million Medicare beneficiaries.

Data management

National Government Services is responsible for managing and keeping secure terabytes of highly sensitive federal health care data from a number of sources. As a government-approved data center, we manage an authentication directory for 25 million+ users.

Customer relationship management (CRM)

On a daily basis, National Government Services manages large volumes of data from various sources and transposes that information into user-friendly environments. As evidence, our work on the Next Generation Desktop contract with CMS is documented as one of the largest CRM implementations in the federal health sector.

Our CRM is an industry leader known for:

  • Managing 4.5 terabytes of contract-related data
  • Supporting 20,000 concurrent users
  • Being appraised at CMMI Level 5

Security

The health data and hosted systems held by National Government Services require the highest degree of protection and data integrity. Our team has deep expertise working with PHI and PII and remains in full compliance with all government security requirements, including the Federal Information Security Management Act (FISMA), National Institute of Standards and Technology (NIST), National Security Agency (NSA) and Defense Information Systems Agency (DISA).

With our robust security program, we secure data for approximately 230 million annual claims and 370,000 providers.

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