Improve provider network management with advanced technology.
To be competitive in today’s healthcare market, payers must constantly strive to increase efficiency, consistency and accuracy. Managing the provider network is a critical part of this objective. With superior provider network management, payers can negotiate contracts for optimal financial results, manage the network with greater efficiency, and process claims with greater accuracy to reduce cost and errors and to increase provider satisfaction. When seeking healthcare information technology to help them improve provider network management, more payers today turn to TriZetto.
Learn more about TriZetto’s provider network management solutions.
TriZetto NetworX Suite® streamlines and automates provider network management.
TriZetto NetworX Suite of products provides comprehensive provider network management tools for payer organizations. The NetworX Suite, leverages patented and patent-pending functionality to automate many aspects of contract modeling, contract execution, claims pricing and payment bundling to help payers reduce costs, increase efficiency and achieve business objectives more easily. An English-language-based interface makes the network management applications easily accessible to users throughout the organization. With support for ICD-10 compliance and the ability to integrate into any core administrative system, the NetworX Suite provides an end-to-end network management solution that allows payers to achieve quick return on investment.
Negotiate provider contracts, simplify contract management, and improve network relationships.
TriZetto’s NetworX Suite gives payers the tools to:
• Negotiate optimal provider contracts. The NetworX Modeler® application automates many contract modeling tasks, enabling payers to analyze the financial impact of potential network contracts in a fraction of the time it takes to do it manually and helping to ensure optimal financial benefits in final contracts. The NetworX Modeler Analytics™ solution adds additional management functionality, allowing users to drill down on provider data and produce customized reports on “what if” scenarios.
• Price claims more efficiently. The NetworX Pricer® application automates claims pricing on even the most complex provider contracts up to 100% and increases efficiency.
• Automate payment bundling. As a value-based reimbursement model, payment bundling can provide significant cost benefits to payers but can be difficult to manage, especially on a large scale. TriZetto’s NetworX Payment Bundling Administration™ solution is a comprehensive and highly automated management solution that enables payers to administrate episode-of-care payments easily and cost-efficiently. The application automatically aggregates, processes and re-prices claims, issuing a single payment to the administrative provider.
Learn more now about provider network management solutions from TriZetto, as well as TriZetto solutions for business process outsourcing, claims management systems, health insurance incentives, revenue cycle management, and more.