With millions of individuals projected to purchase insurance through the newly formed Exchanges, health plans require a partner that understands federal and state requirements and a solution that provides comprehensive capabilities. Enrolling and reconciling payments and subsidies in Health Insurance Exchanges is a complex endeavor. Choosing the right partner is one of the most important decisions a health plan can make to enable efficient operations and success in the new marketplace.
TriZetto solutions address a wide-scope of healthcare reform topics and currently support more than 53 health plan clients in 30 states as they participate in Health Insurance Exchanges. Leading health plans are partnering with TriZetto for exchange-ready capabilities that provide speed-to-use and the ability to manage the complexity of operations from enrollment to reconciling payments and subsidies. With an agile technology platform and a complement of efficient outsourcing services options, TriZetto helps health plans to be better positioned for success today and address the future demands of healthcare reform. For Exchanges, many leading Health Plans are putting their trust in TriZetto, a leader. Solution components include:
TriZetto’s agile development approach across the portfolio provides Exchange-ready capabilities to address federal and state Exchange topics from enrollment to claims payment. Designed to support health plans participating in the Exchanges, TriZetto’s platforms configure and administer Essential Health Benefits (EHB’s) within the core system and address the vital functions necessary to support the rapidly evolving Exchange environment. With our ongoing investment in solutions to help you manage compliance and address rapidly changing requirements TriZetto Facets™ and QNXT™ core administration systems enable health plans to optimize their core system investment to participate in the Exchanges by addressing the following requirements of the Exchange including:
TriZetto’s Exchange capabilities help clients navigate uncharted waters with a wide range of technical, consulting, training and business management services. Our knowledgeable professionals leverage best practices, repeatable processes and utilize proprietary tools to get support our clients Exchange-readiness needs.
Our Exchange Services Include:
Learn more about TriZetto’s solutions for Exchange [marketplaces], as well as other TriZetto solutions for core administration, healthcare claim processing and more.
Comprehensive Capabilities to Participate in Healthcare Insurance Exchanges
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TriZetto provides leading healthcare IT solutions for payers and providers. TriZetto promotes integrated care management by offering comprehensive solutions for care management software, claims management services, network management solutions and more. With solutions for care management, patient-centered medical home (PCMH) solutions, payment bundling and other innovative models, TriZetto is helping reduce the cost, improve the quality of care and transform the healthcare industry.