TriZetto has partnered with Gorman Health Group, LLC, to enable payer organizations to successfully participate in federal and state-based Health Insurance Exchanges. Gorman Health Group’s web-based software Valencia™ integrates with the TriZetto core administrative platforms, Facets™ and QNXT™, and extends the existing Exchange functionality to perform the complex reconciliation of membership and payments.
The Valencia solution enables health plans to quickly and effectively analyze data from the 834 (enrollment/membership) and 820 (payment/financial) transactions to create a view into discrepancies and offers the following benefits:
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.