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With passage of the Medicare Prescription Drug Improvement and Modernization Act of 2006 (MMA), the federal government has presented new opportunities and challenges to Medicare Advantage plans. Capturing or increasing your share of the growing and competitive Medicare Advantage market-and profiting from it-demands new levels of administrative efficiency, accuracy and accountability.

TriZetto offer comprehensive Medicare solutions that include the Facets and QNXT enterprise application systems and other software applications that support the complex needs of Medicare Advantage plans.

TriZetto solutions allow you to meet requirements within the key areas of required competencies including Medicare and Part D Administration, Medicare Revenue Realization, and Revenue and Cost Management.

Administrative efficiency is critical for a Medicare plan as it strives to keep current with CMS requirements. Our core administration systems, Facets and QNXT offer current functionality that supports both Medicare Advantage and Medicare Part D requirements.

Through its Plan Data Management division, TriZetto offers an array of additional Medicare solutions that help plans in these key areas:

  • Enrollment Administration
  • HCC Revenue Management
  • Financial Reconciliation
  • Claims and PDE Administration

TriZetto solutions serve more than 35 percent of Medicare Advantage lives today.

Benefits

  • Comprehensive Medicare functionality ready to efficiently handle claims processing as well as enrollment, reconciliation, billing, medical-management, workflow processes and other key needs
  • Automation of the full spectrum of care management activities for the Medicare population
  • Solution that will continue to adapt as Medicare reporting requirements and other administrative demands evolve
  • A choice of delivery options to match your business requirements and budget including both hosting and BPO services
  • Complete Part D solution to handle complex enrollment and reconciliation requirements
  • Fraud, Waste and Abuse services including CMS -required training for Part D plans


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

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Access TriZetto's Thinking About Government: The Next Steps series to learn more about changes in Medicare. Read the latest

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