Managing claims accumulator data in a timely fashion can be both difficult and costly to a health plan. Accumulators are the method of precisely collecting and calculating total claim dollar values against plan deductibles and benefit limits. Accumulators that are shared between core medical and third party benefits partners such as pharmacy, mental health, dental and vision can result in data that is out of synch.
With increased risk of incorrectly paying claims, the numerous hours to reconcile and potential impact to bottom-line results, many plans resort to manual processes to address this problem. The solution: Facets Accumulator Synchronization™.
TriZetto’s Facets Accumulator Synchronization solution helps:
The Facets Accumulator Synchronization solution is pre-mapped to the Facets core administration platform, allowing rapid implementation and smooth integration. The solution may be purchased and deployed on a licensed or hosted basis.
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As a leading provider of healthcare IT solutions for payers and providers, TriZetto delivers innovative claims management systems, clinical care management solutions, core administration software and network management solutions that help reduce costs, streamline administration and improve the quality of care. TriZetto’s leading edge solutions are helping to transform the healthcare industry by better aligning health insurance incentives, speeding healthcare claim processing, promoting value-based benefits, improving population health management, and reducing the cost of claims processing services and supporting the accountable care organization.