Payment bundling is a value-based reimbursement methodology that focuses on episode-of-care payments to providers. A payment bundle covers all services within a defined unit of care, which includes multiple providers in various settings for a single patient. The TriZetto NetworX Payment Bundling Administration™ solution operates as a re-pricing engine that transforms existing fee-for-service claims into payment bundles.

NetworX Payment Bundling Administration™ is a comprehensive, highly automated solution that administers episode-of-care payments. The application tightly integrates with TriZetto as well as non-TriZetto claim systems and prospectively aggregates claims into bundles for processing and payment. The patent-pending solution includes pre-configured, industry-standard bundles and allows for customization of bundles. The NetworX Payment Bundling Administration solution rewards providers for the value, not volume of care delivered and can help reduce medical costs, leading to immediate ROI.

The benefits of NetworX Payment Bundling Administration:

• Features prospective payment where the full bundle price is paid at the time of adjudication as well as retrospective payment to supplement fee-for-service claims.
• Provides tight integration with Facets, NetworX and non-TriZetto core systems.
• Offers automated payment bundles for episodes ranging from select inpatient and outpatient procedures from acute to chronic care.
• Further, TriZetto’s product gives customers the ability to modify or add their own bundle designs.