• Core – Facets™ Workshops

    Workshop I - Monday, May 21, 11:30 a.m. - 12:45 p.m.

    FS.01   Facets™ – Release 5.01 and Beyond

    Please join this workshop to hear about the newest features in Facets 5.01 and what is coming in the next Facets release.   Discussion topics will include health care reform and 5010 compliance, Medicare enhancements, Payment Bundling Administration, Patient-Centered Medical Home programs, modernization of User Interface, Workflow extensibility, NetworX Pricer® and CDH enhancements.

    FS.02   Administrative Simplification

    Are your Facets™ business users and IT professionals in the know?   Join us for an informative discussion of Facets support for the new HIPAA Standards and Operating Rules associated with the January 1 2013 and 2014 milestones dates for health plans.   In the session we will cover the new HIPAA standards for the unique Health Plan Identifier (HPID) and payment to providers via the mandated EFT format.   In addition, we’ll explore how Facets can help your organization with the Eligibility/Claims Status and Claims Remittance/EFT Operating Rules and other healthcare reform initiatives.

    FS.03   Consumer Retail and Facets™ Enrollment

    In this workshop, we will provide information on how Facets will be moving to a more member-centric model, with support for exchanges to help plans compete for and retain membership.   We will provide information on the enhancements that will support this model.

    FS.04   A New Approach to Upgrades: TriZetto® Upgrade Center

    What do you get when you consolidate expert resources focused solely on specific areas of work, leveraging repeatable, scalable tools and processes?   The TriZetto® Upgrade Center, that's what.   See examples of how a customer can actually reduce work effort while experiencing a more rapid speed-to-value.

    FS.05   Payment Bundling 101

    Payment bundling can be a very successful part of both payer and provider strategies — when implemented correctly.  This session will cover the basics of payment bundling, including: prospective versus retrospective methods; operational and technical challenges that should be addressed before starting a program; and lessons learned from current programs in the industry.

    FS.06   The Facets™ Technology Roadmap

    Explore the strategy and direction of Facets™ technology, including what is new in release 5.0 and where the Facets™ solution is going.   A major new component of Facets 5.0 is the new presentation (User Interface).

    FS.102   Managing Encounter Data Submissions for Medicaid & Medicare  

    This workshop demonstrates the latest features and functionality of Encounter Data Manager, a complete encounter data submission and management tool.  This interactive session will demonstrate numerous practical uses of the application including gathering, scrubbing, submitting, tracking, reporting and reconciliation of encounter data.

    Workshop II - Monday, May 21, 1:45 p.m. - 3:00 p.m.

    FS.07   Facets™ User Interface

    Have you seen it?   Want to hear what is next?   Come learn about the Facets™ 5.01 improved user interface, including how features like the new "Favorites" and "Embedded Browser Apps" can improve the user experience in Facets. We will introduce you to new features that will be coming your way in future releases.

    FS.08   Improving Provider Collaboration: What's New in Provider POS Direct™ 5.0?

    With new pressures from healthcare reform, it's no surprise payers are reevaluating how they collaborate with their providers.   Gain an understanding of what's new in Provider POS Direct™ 5.0 and how it can help reduce administrative costs associated with processing paper claims, improve claims payment efficiency and first-pass rates, and improve the overall provider experience.

    FS.09   ICD-10: New Timeline Means New Opportunity  

    Potential changes in ICD-10 compliance dates shouldn’t slow you down.   Health plans have made great strides toward getting their systems and organization ICD-10 ready, but there is still much to do.   Come hear key lessons learned and considerations organization must address as they continue their journey towards achieving ICD-10 compliance.

    FS.10   Managing Your Facets™ Environment

    Managing the Facets™ environment, including best practices for batch processing management and deployment; new instrumentation capabilities/performance and tuning.

    FS.103   Automated Claims Testing with Claim Test Pro

    This workshop demonstrates the latest features and functionality of Claim Test Pro, an automated claims testing application. This interactive session will demonstrate numerous practical uses of the application including system migrations, version upgrades, service/change pack updates, ICD10 implementation, fee schedule updates, benefits and other every day configuration changes.

    FS.104   Automating Physician Pricing to Improve Costs and Relationships

    Pricing the large volume of Medicare physician claims is complicated and has a high potential for overpayment by health plans. Discover how automating the pricing with the sophisticated Physician Pricer technology allows hospital and physician contracts related to federal and state reimbursement to be effectively maintained, updated and negotiated.

    Workshop III - Monday, May 21, 3:15 p.m. - 4:30 p.m.

    FS.11   Reimbursement Strategies and Sharing Risk with Physicians and Facilities

    Patient-centered medical homes, accountable care organizations, and centers of excellence are forms of value-based insurance design being adopted by many plans.   Starting in Facets™ 4.8.1, the new Program feature allows plans to organize information in Facets about such programs, and future enhancements will allow Facets to alter reimbursement and benefits for care delivered in these new programs.   Learn how you can support your plan’s development and adoption of ACOs, PCMH, and centers of excellence using Facets to improve administrative efficiency.

    FS.12   A Panel Discussion on ICD-10

    ICD-10 compliance is approaching quickly.   Join this panel session to talk about your plan's strategy to implement ICD-10 codes, discuss changes in benefit configuration, authorizations, claims processing and reporting in Facets™.   Review action items needed to complete your health plan's readiness.   Share your insights on the impacts on ICD-10 projects while CMS evaluates the possibility of a new compliance date.

    FS.13   Overview of Facets Product Support

    This workshop is an overview of the Facets™ Product Support Organization.   Planned topics of discussion include support certification, service level agreement attainment, support communication vehicles and self-service tool availability.   We also plan to give attendees a guided tour through Customer Exchange from a Facets-user vantage point.   We’ll also share the 2012 initiatives we are implementing as a result of your annual survey feedback and we'll provide an insider's view into our defect identification to scheduled change package process to help improve transparency into the Facets Change Package Delivery Initiatives.

    FS.14   Best Practices in Configuration for Facets™  

    The way you configure business rules for benefit plans, pricing, and provider networks impacts your operational outcomes.  TriZetto has developed the "must know" best practices in Facets configuration. Learn from TriZetto seasoned professionals and come prepared with your most difficult Facets configuration challenges.

    FS.15   Maximizing Optional Features within the Facets™ Solution

    The workshop will explain the benefits of enabling and tuning optional parameters such as: viewing the original electronic claim submission in Facets™; handling claim payment reversals; tuning Facets™ Workflow and Facets™ NetworX caching parameters; starting the broker process as a service; viewing previously generated letters in Facets; and more.

    FS.16   New On-boarding Capabilities: Competing in a New Consumer Retail Market

    An estimated 30 million members are expected to enroll in health plans through new public exchanges.   Competition to serve this new channel, in addition to serving current channels, will be fierce.   Optimizing client acquisitions, servicing and retaining clients, and managing the cost of care will be even more critical.   See what plans can do today to prepare to compete in this new consumer retail market.

    FS.17   Speed, Quality and Compliance: What's TriZetto Up To?

    The new TriZetto is transforming the way we develop and deliver our solutions.   We are increasing our speed to market through a new iterative release process.   Clients need us to deliver high quality so they’re able install more frequent releases with confidence.   TriZetto has engaged an industry-leading consulting firm to help us implement best practices to enable higher quality, and we’ve created a Compliance and Certification team to help ensure that we keep abreast of the constantly changing regulatory environment so that we can help clients, in turn, meet their ongoing compliance requirements.   This workshop will provide you with an inside view of what TriZetto’s doing to better serve you in these areas.

    Workshop IV - Tuesday, May 22, 11:15 a.m. - 12:30 p.m.

    FS.18   Facets™ – Release 5.01 and Beyond

    Please join this workshop to hear about the newest features in Facets 5.01 and what is coming in the next Facets release.   Discussion topics will include health care Reform and 5010 compliance, Medicare enhancements, Payment Bundling Administration, Patient-Centered Medical Home programs, modernization of User Interface, Facets Workflow extensibility, NetworX Pricer® and CDH enhancements.

    FS.19   Facets™ Plan Building 101

    This workshop will offer a basic overview of the components needed to set up a functioning Facets product incorporating healthcare reform requirements.   Through demonstrations on the latest version of our software, users will see how the basic plan and product components are completed and how they interact.

    FS.20   Maximizing ROI with your Workflow implementation

    Do you need to increase your claims first-pass rate and timeliness, improve overall accuracy and productivity, reduce paperwork and enhance your ability to monitor employee performance, view inventory and balance receipts in a real-time mode?   Join this panel discussion to learn how Workflow meets and exceeds expectations for ROI.

    FS.21   Prometheus and NetworX Payment Bundling Administration™  

    This workshop will provide an overview of TriZetto’s partnership with industry leader Prometheus, sharing TriZetto’s approach to automation for Prometheus-designed payment bundles.

    FS.22   Turning Feedback into Action Plans  

    Learn how The TriZetto Group put client feedback to work in its Product Development division to develop action plans to identify and address ways to improve business processes. With a well-tuned feedback management system, focus areas can be identified at an enterprise-wide level, within specific operational areas or by key market segments.
    You'll find out how the company made feedback programs a core element in its overall client experience strategy.  
    • Fully integrate real-time client feedback into every business unit.
    • Make the voice of the client a fundamental part of continuous business improvement.
    • Unleash the value of quantitative and qualitative data.
    • Help shape the future.

    FS.23   The New Member Experience via the Web – A Deep Dive into the Next Generation of Consumer Web Solutions

    See the new experience and capabilities payers will be able to offer members.   We will take a deep dive and show a prototype of the new Member Portal — part of the TriZetto Portal Technology 5.0 release.

    FS.101   Understanding Topaz Shared Services  

    BCBS of KC and BCBS of NC have formed an administrative services organization to drive collaboration between Member Blues plans.    This workshop will focus on understanding this shared service model and how it’s leveraging TriZetto software and services.    We’ll provide information on the services such as claim processing, enrollment and billing for the individual, small group and under 65 markets.    We’ll spend some time explaining and reviewing the following:
    You'll find out how the company made feedback programs a core element in its overall client experience strategy.  
    • Focus on individual and small group to position to win an Exchange environment.
    • Leverage shared People, Process, and Technology to significantly reduce administrative cost structure.
    • Gain efficiencies while respecting local market employment. Create a compelling value proposition for other plans to join.
    • Standardize wherever possible while maintaining critical Local Market differentiators.

    FS.105   Maximize the Potential for Payment Integrity

    The traditional method of clinical editing and other payment accuracy initiatives is getting more challenging to maintain and improve efficiency.    This compelling presentation will focus on a new approach that leverages sourced edits, with a rules engine that can help apply analytic edits as well.    Analytic edits could include contractual, COB, FWA, as well as payment policy specific rules.    Discover how these analytic edits and root cause analysis can enable the resolution of overpayments and improve first pass payment integrity.

    Workshop V - Wednesday, May 23, 9:30 a.m. - 10:45 a.m.

    FS.24   Facets™ Supports ICD-10

    Meet the design team for a discussion on ICD-10-related features in Facets™, including the new Supplemental Procedure and Revenue Code Service Conversion Rules and Duplicate codes enablement.

    FS.25   CDH Account Management

    This workshop will discuss the creation and management of the tax-deferred Health Savings Account (HSA), Health Reimbursement Account (HRA) and Flexible Spending Account (FSA) used in conjunction with high-deductible health insurance plans to place more financial responsibility with the insured.

    FS.26   Lessons from Payment Bundling Implementations

    Hear client experiences with payment bundling, lessons learned during implementation, and both short-term and long-term objectives for programs.

    FS.27   Exploring the HIPAA Gateway

    Discussion of the HIPAA Gateway for Facets 5.0, the impact of 5010, and a look at extensibility and integration features.

    FS.28   Using Facets™ to Support Medicaid

    Please join this panel discussion to learn how Medicaid health plans use Facets™ to comply with regulations, streamline processes for enrollment, eligibility and retention, and encourage electronic claim submissions.

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