QNXT™ Close-Up

  • medium-three-computer-right-jpg-362x246With advanced service-oriented architecture, TriZetto's patented QNXT core administration system enables you to transform business operations.

     

    The QNXT solution delivers the flexibility and functionality needed to help increase efficiency and improve performance, helping you compete more effectively in the ever-changing healthcare market. A proven solution, QNXT currently helps nearly 60 health plans and touches 17 million lives.

    Built on an open platform with service-oriented architecture, the QNXT application provides a rules-driven system that you can configure to meet the needs of your organization, and scales easily to serve organizations large and small.

    The QNXT application helps you better coordinate interactions among members, employers, brokers and providers. You can provide decision-makers with the information they need in real time. Increase revenue by filling market demand for consumer-directed health plans. Improve efficiency in key areas of your business, including:

    • Medical and dental claims processing
    • Claims re-pricing
    • Capitation/risk fund management
    • Premium billing
    • Provider network management
    • Group/membership administration
    • Referral management
    • Hospital and medical pre-authorization
    • Case management
    • Customer service
    • Electronic data interchange

     

    The QNXT solution supports payer organizations across all lines of business and provides comprehensive consumer-directed health capabilities with advanced HSA/HRA.


  • Reduce costs through automation.


    In the face of constant pressure to reduce costs, the QNXT solution helps you succeed by automating more processes and reducing manual intervention. With QNXT automation, you can simplify the claims process, improve your first-pass rate and reduce the need for claims analysts to get involved. In fact, QNXT has helped some payers achieve auto-adjudication rates as high as 90 percent—a significant factor in reducing costs.

    Increase competitiveness through integration.


    The QNXT solution lets you easily integrate the technologies you need in order to be more agile, efficient, and adaptive—in short, more competitive.

    The QNXT system integrates with other TriZetto solutions you rely on to effectively manage your business:

    • Claims reimbursement
    • Benefits and contracts management
    • Case management
    • Utilization management
    • Value based solutions
    • Care management
    • Care planning
    • Portal solutions
    • Predictive modeling
    • Payment bundling


    The ease with which QNXT integrates with other systems can help you:

    • Improve accuracy in authorizations by adjudicating requests with the same logic used to adjudicate claims
    • Increase information transparency through easier access to accurate real-time data
    • Engage and reward constituents and personalize interactions by leveraging consolidated data
    • Extend functionality with additional TriZetto components


    The QNXT application alone is a powerful solution. When integrated with other TriZetto components, it is truly unparalleled.