Medical loss ratio (MLR) requirements pose new challenges for payers. These regulations require that group and individual health plans ensure that 80 to 85 percent of premium revenues are spent on healthcare services. Plans that fail to meet these standards will be required to give rebates to members. This intensifies existing pressures for payers to increase efficiency through automation. That’s where TriZetto can help.
To help you create a more efficient organization, TriZetto provides tools that automate processes in key aspects of the business. TriZetto’s scalable, flexible technology improves workflow processes, lowers staffing requirements and reduces costly maintenance and inefficient claims processing. Our Application Services, BPO Services and Consulting Services provide additional help for greater efficiency and savings.
Payment bundling holds great promise as a way to improve the cost-effectiveness and quality of healthcare
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TriZetto provides leading healthcare IT solutions for payers and providers. TriZetto promotes integrated care management by offering comprehensive solutions for care management software, claims management services, network management solutions and more. With solutions for care management, patient-centered medical home (PCMH) solutions, payment bundling and other innovative models, TriZetto is helping reduce the cost, improve the quality of care and transform the healthcare industry.