Our efforts include:

• Fraud prevention plan development
• Operational and compliance assessment and monitoring programs
• Web-based fraud awareness training courseware

Fraud Prevention Plans: TriZetto consultants work with each client to customize standard fraud plans in order to meet unique compliance and operational needs. TriZetto helps develop policies and procedures that support the components of the prevention plan and assist the client in complying with all federal, state and contractual obligations.

Assessment and Monitoring Program: TriZetto audits operation documentation and conducts employee and related-entity interviews, using such resources as audit guides and contracts. These are designed to identify any compliance deficiencies within the organizations' fraud prevention operation. TriZetto provides a comprehensive audit report that summarizes the methods, findings and specific recommendations to become compliant. For operational assessments, TriZetto consultants review policies and procedures to identify opportunities to improve the fraud prevention plan.

Web-based Fraud Awareness Training Courseware: Available on an ASP basis or as part of a plan's existing learning management system, TriZetto has up-to-date and effective fraud awareness learning modules covering all lines of business, including Part D requirements. The application also includes robust tracking and reporting capabilities.

Benefits

• Helps your health plan achieve compliance with federal, state and contractual requirements
• Identifies deficiencies in existing fraud prevention operations and recommends solutions to these
• Delivers the awareness training that your employees need

Information

For more detailed information, please call 1-800-569-1222 or click on the link below. Request more information     Contact a sales rep