NaVcare

Placing the patient at the center of care to improve utilization, member satisfaction and health outcomes.

With in-depth knowledge of the health plan and data-driven insights that illuminate individual care needs, NaVcare helps ensure members receive the right care in the right place from the right providers. Working one-on-one with plan members, our care navigators provide a single point of entry into the Vālenz™ ecosystem and deliver personalized, concierge-level guidance through each step of the patient journey.

Integrating Data and Service for Meaningful Results

As part of our URAC-accredited Vālenz Care suite of services for case management, disease management and utilization management, NaVcare combines insightful data with service delivery to improve care and lower costs. Based on ecosystem intelligence from multiple sources – including claim, pharmaceutical and demographic data – we tailor our NaVcare program to each employer and personalize services for each member.

Starting with high-touch member onboarding, we engage early and often using concierge-level navigation to empower individuals to make better health decisions while controlling costs, improving outcomes and enhancing their experience.

When integrated with the full Valenz ecosystem, real time insight allow us to pinpoint the 5-15% of claims that result in up to 70% of the employer’s health spend. As a result, NaVcare navigators can proactively identify members with complex, chronic conditions who may benefit from comprehensive care management, avoiding more serious and high-dollar events.

Providing a Central Hub for Care Coordination

NaVcare improves utilization, member satisfaction and health outcomes through effective education, collaboration and communication. Our navigators are coverage and benefits experts that use their detailed knowledge of the health plan, care plan and provider network to guide members toward high-quality, low-cost care and medication.

NaVcare concierge-level service:

  • Guide members to in-network facilities and providers
  • Introduce virtual care solutions when integrated
  • Facilitate appointments, including transportation as needed
  • Identify and coordinate cost-effective pharmacy  solutions
  • Answer questions about benefits, eligibility, out-of-pocket costs and provider billing
  • Serve as central point of contact for everyone across the care continuum, from members and families to administrators, benefit consultants, payers and care providers
  • Connect members to available cost containment solutions
  • Assist members with claim denials and appeals