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Adding new products or lines of business, expanding into new geographic regions, and growing your provider network all require changes to the configuration of your Facets® and NetworX™ Pricer solutions. These changes help ensure a consistent auto-adjudication rate; however, the expertise to perform these configurations may be hard to find and not required throughout the entire year.
TriZetto Business Rules Configuration (BRC) Services can help you rapidly configure benefit plans, provider networks and pricing. A highly seasoned team of experts in both the Facets and NetworX Pricer applications can help you quickly and cost-effectively update your products or enter a new line of business.
Using proven business templates and best practices, TriZetto experts can build and maintain your code sets, benefit plans (or product) and pricing agreements for Medicare, Medicaid, HMO, PPO, POS, Dental and ASO product lines. They can also build and optimize your pricing configurations, including: Fee-For-Service, DRG and DRG Grouper, Percent RBRBS, Medicare and Medicaid schedules, Capitation, Facility, Professional and Clinical Editing criteria. And they can manage your code sets, including ICD-9, DRG, HCPCS, CPT codes, Diagnostic codes, Place-of-Service codes, and EOB/EOP Explanation codes, to name a few.
Benefits of TriZetto Business Rules Configuration Service include:
- Decreased time to market with new products, networks and lines of business
- Better capacity management
- Lower administrative costs
- Simplified benefit plan maintenance and renewal processes
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Information
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For more detailed information, please call 1-800-569-1222 or click on the link below.
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