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First to market, and still leading the way - ACS partnered with the Bank of New York Mellon Corporation to introduce HSAs in 2004, and is currently the largest HSA administrator in the nation serving more than 450,000 accountholders, 23,000 employers, and 50 distribution partners. Our health plan and TPA partners rely on us to deliver a best-in-class, integrated HSA solution to their organization, employer groups, agents, brokers and members.
ACS is a FORTUNE 500 provider of diversified business process outsourcing and information technology solutions. With unparalleled growth and client retention, ACS supports global operations with over $5 billion in annual revenue. For more information visit www.hsamember.com.
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ACTEK is a TriZetto partner selected to provide a comprehensive commission and incentive compensation solution to the QNXT customer base. ACTEK's products deliver the power and flexibility to fully automate the commission and bonus payout function with support for brokers, agencies, internal sales staff and management.
The best-executed commission programs deliver timely and accurate results while offering the flexibility to support diverse business relationships across your producer population.
ACTEK's ACom3 software automates commission and compliance management for agents, brokers, and other producers and delivers value by reducing operational costs, ensuring compliance, and supporting corporate compensation strategy. Highly scaleable and with an intuitive Internet interface, ACom3 incorporates the lessons learned from 20 years of developing software for the health insurance industry.
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AVOLENT is a leading provider of best-of-breed electronic billing and settlement software. The AVOLENT suite of applications transforms an organization's paper-based and manually intensive billing process into a self-service web environment that build customer loyalty by increasing customer satisfaction, improving operational efficiencies, and saving our natural resources. Companies like DELL, Hewlett-Packard, Highmark, Pacificare, Office Depot, Penske Leasing, and many others use AVOLENT as their electronic billing and settlement engine to process over one billion dollars of invoices per week on the web and save over one million trees every year. AVOLENT is headquartered in San Francisco, CA. For additional information about AVOLENT, visit www.avolent.com.
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Cincom Document Solutions (document automation division of Cincom Systems, Inc.) provides the most-intuitive dynamic document automation solutions in the industry. From interactive generation of claims correspondence to fully-automated archive and retrieval of policies, our software solutions have helped hundreds of insurers worldwide strengthen member relationships, minimize compliance risks, and reduce operating costs by streamlining the design, deployment, delivery, and management of high-volume, personalized document communications. With over two decades of experience, Cincom Document Solutions leads the industry in providing dynamic document solutions that are easy to use, seamlessly integrate in legacy environments, and deliver rapid and continuous return on investment.
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ClearCycle has been a leading claims disbursement solution provider utilized by many progressive healthcare payers for more than two decades. The ClearCycle systems settle and processes over $1 billion per day. ClearCycle delivers effective output management and financial controls and systematic handling of claims and financial payment adjustments including overpayment recovery.
ClearCycle's Universal Claims Disbursement System© (UCDS©) is a comprehensive back-end financial solution that handles all aspects of paying electronic & paper claims and managing financial information including a member/provider payment portal. ClearCycle will help you reduce administrative costs by allowing members, providers, and employer user communities to access the disbursement information directly.
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Eliza Corporation's phone-based, speech-enabled programs will be an integrated part of the TriZetto CareAdvance platform. Our proven approach enables healthcare organizations to cost-effectively communicate with the people they serve – driving ongoing behavior change that leads to measurable clinical and financial outcomes. Throughout our more than 200 million calls, we have developed a unique evidence-based methodology on how to design these interactions to be personal, relevant, and effective.
Eliza leads the market with the strongest track record of innovation and outcomes, the broadest range of proven programs, and the most comprehensive suite of patented technologies and approaches. Clients include nine of the top ten largest national health plans, four of the top five disease management companies, three of the top four pharmacy benefit managers, six of the top ten pharmaceutical companies in the nation, as well as large employers and leading third party administrators. Visit www.elizacorp.com or call 978-921-2700.
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Emptoris provides contract management software that delivers greater control and more profitable contracts for some of the world's largest, most contract-intensive enterprises. With Emptoris' solutions, organizations are able to create stronger agreements, cut claim reprocessing costs, and improve compliance. Emptoris Contracts also plays an integral role in companies' risk management and corporate governance programs. Leading healthcare payers such as United Healthcare and CIGNA depend on Emptoris Contracts. For more information about Emptoris solutions, visit www.emptoris.com or call 1-888-496-2600.
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FutureVision currently converts over 40,000 paper claims a day to EDI within 24 hours of receipt for TriZetto clients. FutureVision's paper-to-EDI conversion service allows payers to receive and process 100% of their claims as EDI, can be implemented in 30 days, and has been in use by QNXT customers for the last seven years.
FutureVision is an outsourced solutions provider specializing in document and information management solutions. Our clients to benefit from cutting-edge technologies without the financial, IT, and personnel investments traditionally required. Our services create generate real savings in operating budgets without capital expenditure.
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Healthwise is a nonprofit organization that helps people make better health decisions. Implement the Healthwise® Ix® Solution-with TriZetto's Personal CareAdvance and Clinical Care Advance care management-to help people do more for themselves, ask for the care they need, and say "no" to the care they don't need. Key and Smart Campaigns can help reduce costs and improve health care quality and staffing. Talk to TriZetto representatives, or contact Healthwise at www.healthwise.org (800) 706-9646.
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HSS, Inc. is the nationally recognized leader in state-of-the-art solutions that help payers effectively utilize prospective payment to manage risk, optimize contracting, reduce costs and improve data quality. HSS' expertise in deciphering the complex rules of compliance and claims payment is just one of the many reasons why over 160 managed care organizations have chosen HSS for prospective payment solutions. By integrating Facets with EASYGroup, HSS' portable software library of groupers, pricers, editors and other tools, payers can effectively utilize prospective payment to save as much as 60% on Medicare+Choice out-of-network claims payments, assess provider performance, and shift to providers the portion of risk that they can effectively manage. The Facets/EASYGroup solution may either be licensed, or hosted by TriZetto. When utilized as a hosted solution, regulatory updates are executed automatically and on-time by HSS, giving you the peace of mind that comes with knowing that you're always operating in compliance with current regulations.
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Ingenix unites the brightest minds to transform organizations and improve health care through information and technology. Together with our clients and business partners, Ingenix is improving the affordability, quality, usability, and accessibility of health care.
Health plans integrate numerous TriZetto and Ingenix solutions to drive efficiency into claims adjudication, pricing and care management processes. Ingenix data, analytics, and software can help health plans streamline claims processing workflows, reduce reimbursement errors, improve payment integrity, manage risk, optimize provider contracting, and target health care services to those members who will benefit most.
Today there is an Ingenix solution at work in nearly every U.S. health care organization. Learn more at Ingenix.com or call (800) 765-6713.
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Innovative Health Solutions, an ACCURO Company, is a leading provider of nationally recognized coding, compliance, reimbursement and decision support solutions. IHS provides Medicare Grouper and Pricer systems for over half of the Payors.
IHS groupers and Pricers are accurate, fast, affordable and run on all platforms. TriZetto’s NetworX applications can be configured to use IHS’ Medicare Groupers and Pricers.
IHS is strategically aligned with 3M Health Information Systems to distribute 3M's comprehensive product line of grouper software to payers including the APRDRG and CRG Groupers.
For more information, visit us at www.innovativehealthsolutions.com or call toll free 866.822.6700.
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Kryptiq is the leading provider of next generation healthcare connectivity solutions, enabling healthcare providers and health plans to utilize and share vital information effectively. Kryptiq’s award-winning Connect IQ and Choreo solutions are being adopted by many of America’s top providers, health plans, and leading healthcare IT vendors to achieve new levels of mobility, accessibility, and visibility to critical information. For health plans, Kryptiq’s Choreo product suite transforms provider contracting and network management processes. Choreo provides the information transparency and process automation necessary to competitively grow and manage provider networks. www.kryptiq.com
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MBI Benefits, a Metavante Healthcare Payments Solutions company, offers a consumer-directed health benefits payment platform plus the country's #1 employee benefits card - electronically accessing FSAs, health reimbursement arrangements (HRA), health savings accounts (HSA), transit/parking accounts and dependent care accounts. Metavante provides medical identification cards, combination eligibility/payment cards, and the ability to access multiple benefits accounts from a single card. Metavante also provides a comprehensive payment platform that provides all the technology a financial institution, health insurance company, third-party administrator, or commercial business needs to offer these accounts. To learn more, visit www.metavantehealthcare.com.
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McKesson Corp. is the country's largest healthcare services company and the market-leading provider of code auditing solutions. Our ClaimCheck® code auditing solution is powered by McKesson's massive clinical knowledgebase, refined through nearly 20 years of use by plans of all sizes across the country, and applied to billions of claims.
ClaimCheck reviews claims against our sourced, credible knowledgebase to identify mismatches - coding combinations that authoritative sources have declared improbable or unacceptable. This McKesson solution helps plans improve operations through increased auto-adjudication, enhanced productivity and reduced administrative costs.
ClaimCheck's expanded editing flexibility enables plans to manage healthcare claims according to medical and business policies. It offers Trizetto customers a direct pathway to rules-based adjudication to better "mirror" their organization's specific policies, improve accuracy, reduce manual reviews, and reimburse providers more efficiently. The combined, powerful performance of McKesson's ClaimCheck auditing solution with Trizetto's Facets system can help health plans meet and even exceed their claims performance objectives.
For more information, please visit McKesson.com website or call us at 800.782.1334.
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Medical Data Express: Focusing on providing expert technology consulting and solutions to the healthcare market.
The professionals at Medical Data Express provide accurate and timely solutions backed by the guarantee that they will be achieved within budget.
Xpress Encounter Pro handles all extraction, tracking, correction, reporting and archiving of encounter data and supports Medicaid and Medicare for one or many states.
Xpress Claim Test Pro provides an extremely efficient environment for organizing and performing claims testing on a target system. Test cases are created and organized by the user from an existing claims source and then extracted into an 837 or printed forms for testing on the target system.
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Micro-Dyn Medical Systems, Inc., founded in 1989, specializes in software products for healthcare claim DRG calculation, APC assignment, Medicare reimbursement calculation, data editing, and validation to Medicare specifications. Our customers include health plans, hospitals, healthcare software vendors, and companies like yours!
Our expertise grew out of our work on the original installations of DRGs and the Inpatient Prospective Payment System (PPS) used by Medicare contractors beginning in 1983. Our DRGActive™, APCActive™, and PRICERActive™ software and data editing components integrate seamlessly with your QNXT installation to easily add data validation, DRG/APC calculation and Medicare reimbursement capability.
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The Milliman Care Guidelines® are clinical decision support tools used for treating specific patient conditions with appropriate levels of care and optimal progression toward discharge or transition. Developed by clinical experts, they provide a focused summary of the current best evidence, reflecting the actual practices of care providers throughout the United States, as well as the latest medical literature. Designed to be used in conjunction with healthcare professionals’ clinical judgment, the Care Guidelines provide up-to-date, evidence-based knowledge, enabling more informed, consistent decisions and promoting the best possible care management. For more information, visit www.careguidelines.com.
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Post-N-Track is a simple, secure and HIPAA-compliant transaction exchange platform comprising a new generation of Web services and Web tools. Post-N-Track eliminates transaction intermediaries by enabling direct "posting" and "tracking" of administrative, financial and clinical transactions and information between payers, health care providers, billing entities, banks, employers and other trading partners of any size.
TriZetto and Post-N-Track have formed a strategic partnership to offer QNXT customers a phased methodology to enable the end-to-end, Real-Time Payer Enterprise. The partnership allows QNXT customers to embrace increasing levels of real-time performance at their own pace with a phased migration path: (1) real-time claims acquisition, (2) real-time acquisition and adjudication, and (3) real-time acquisition, adjudication and payment.
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RxEOB enables health plans and benefits administrators to deliver personalized pharmacy benefit decision-support tools directly to their members via the Internet. Integrated into the client's website in a secure HIPAA-compliant environment, RxEOB gathers data from a variety of disparate sources and repackages the actionable information for three constituents: the consumer, the health plan/benefits administrator and the health plan sponsor. Our tools allow for delivery of a member benefit-specific pricing guide to drug therapy options empowering consumers to take a more active role in helping control drug costs. Health plans can use the tools to access aggregate and individual Rx information for care management, customer service, plan modeling and formulary development. Health plan sponsors have access to a co-branded, customized site reinforcing the health plan's accessibility and increasing web traffic. For more information go to: www.rxeob.net.
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SOCRATES, INC. is the only healthcare Subrogation/ Reimbursement firm that provides both outsourcing services and software programs enabling TriZetto customers to achieve recovery rates that exceed industry norms with unparalleled case management. The MY SOCRATES© software was developed by accounting, legal, computer science and healthcare experts. It serves as the engine which drives our subrogation/reimbursement outsourcing service. MY SOCRATES can also be licensed by health payors for in-house use. With over 15-years of subrogation experience and industry knowledge, SOCRATES, INC. serves the healthcare payor industry with a diverse customer portfolio including health plans, TPAs, consumer-directed plans, self-funded plans, HMOs, PPOs, POSs, governmental plans, and Medicaid & Medicare administrators.
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Information
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For more detailed information, please call 1-800-569-1222 or click on the link below.
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