Efficient, reliable solutions to help you capture your share of the medicare advantage and Part D markets—and profit from it.
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More than 30 percent of all Medicare Advantage and Part D lives are processed on TriZetto core systems. TriZetto has the experience and capabilities covering the continuum from enrollment through financial reconciliation to HCC Revenue Management. We help health plans adapt and respond quickly to changes serving their Medicare Advantage populations. Our clients gain efficiencies to address the complexities of Medicare Advantage plans including the Affordable Care Act’s MLR requirement, continually evolving CMS mandates, and improving the cost and delivery of care. We focus on managing efficient operations, so our clients can focus on continuing to drive quality and member satisfaction.
The complexity of rules and workflows required by CMS are vast. TriZetto monitors regulatory changes daily to support our many Medicare Advantage and Part D clients. We also leverage a team of professionals with many years of combined Medicare experience in the industry. They help TriZetto proactively plan strategies that help clients address new regulations and requirements with a focus on minimizing the effect on costs and productivity that could impact their business.
TriZetto provides a comprehensive portfolio of capabilities to meet the specific needs of your business. Our advanced technology platform helps strategically position you for the future and the demands of healthcare reform. We help address a wide scope of business needs through capabilities that enable you to:
Our world-class services include application hosting and management, business process services, and consulting. TriZetto’s application hosting and management are delivered via cloud technologies to give clients flexible and scalable business services. Our global team of experienced professionals possesses deep knowledge of both the healthcare industry and TriZetto solutions, helping clients solve their unique business challenges and achieve results more quickly.
Provides key capabilities for health plans that are expanding into the Medicare Advantage market or looking to improve efficiencies within their existing operations. Through this outsourced solution, the TriZetto Medicare Management Solution™ provides the technology and operational foundation to launch and efficiently manage your comprehensive Medicare Advantage business, so you can better focus on strategic growth at a predictable cost.
The HCC Risk Adjustment Manager helps Medicare payers better optimize revenue through improved data collection, which generates more accurate risk scores and, therefore, more accurate payments.
Efficient, reliable solution supports increased speed to market
Helps Medicare payers better optimize revenue through improved data collection
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TriZetto provides leading healthcare information technology for payers and providers. From claims processing and advanced network management to case management solutions and HIPAA Compliance with 5010 implementation, TriZetto healthcare technology management solutions help reduce costs, streamline administration and improve the quality of care. TriZetto’s network management services help payers improve provider network management with tools for contract modeling, claims pricing, payment bundling and more. And TriZetto solutions give healthcare organizations the ability to achieve compliance with ICD-10 and 5010 HIPAA regulations more easily and cost-effectively.