Healthcare reform, ICD–10, and updates to networks and products are just a few of the factors driving frequent changes to the configuration of your core administration and network management platforms. Such changes, which seem to increase in number every year, can make the difference between a smoothly running claims-adjudication process and one that pends large numbers of claims and forces costly manual interventions.

Proper configuration of your benefit plans, provider pricing and networks is essential to your efforts to keep administrative costs low and support the products you need as you compete to win in your marketplace.

TriZetto Configuration Services helped one payer reduce its base product configurations by 93% – from more than 2,000 to just 147. That saved the company $5 per member per month in long-term configuration support costs.

TriZetto® Configuration Services can deliver multiple benefits, including:

• Reduced administration costs by 20% to 40%
• Faster time-to-market for new products, networks and lines of business
• Better capacity management during periods of peak demand, improving auto-adjudication rates and increasing administrative efficiencies
• Simplified maintenance of benefit plans

TriZetto Configuration Services include:

• Benefit plan configuration
• Pricing configuration
• Provider network configuration
• Broker configuration

Flexible delivery models – Payers can outsource on an ongoing basis or as needed to complete “on demand” projects. And payers can choose to outsource pieces of the business or entire business processes.

Flexible sourcing models – With more than 700 professionals, 70% of whom have college degrees, working in onshore and offshore facilities, TriZetto can help meet the scale, scope and cost demands of any payer organization.