The TriZetto Facets™ application provides a core administrative platform that can integrate all your lines of business, including:
The Facets application can scale to meet the demands of the largest payers. With leading-edge functionality, the Facets solution helps reduce administrative costs through improved auto-adjudication, integrated workflow management and greater operational efficiency.
TriZetto’s comprehensive solutions serve more than 33 percent of Medicare Advantage lives today. With the Facets application, you can support Medicare Advantage and Medicare Part D accretions, changes and deletions, and direct-bill beneficiaries for premiums. The Facets system also supports client service appeals and grievances, reconciles CMS payments, and provides detailed support for discrepancies and retroactive adjustments.
More than 37 percent of all managed Medicaid claims are now processed on TriZetto applications. The Facets system is an industry-leading Medicaid solution, handling claims processing efficiently and delivering effective enrollment, medical management and workflow processes.
The Facets Disability module helps you establish and administer parameters for long-term and short-term disability claims, including payment frequencies and benefit calculations. Facets Disability also manages processing operations for short-term and long-term disability benefits, from specifying a benefit plan and establishing claim and payment generation, to processing year-end W-2 information.
Facets Dental provides comprehensive functionality to support your dental business today and scales easily to accommodate growth. With fingertip access to dental-specific functionality, Facets Dental simplifies your dental configurations, automates workflows and increases auto-adjudication. You can improve member satisfaction by pre-determining coverage and out-of-pocket member expenses. And a flexible and highly configurable interface—including built-in preventive-care models—makes it easy to bring new products to market quickly.
The new Facets Vision module helps you automate and administer provider-reimbursement models for vision benefits. Facets Vision supports complex and flexible benefit programs, helping you process claims in real-time, using portals and online views. And you can automatically create additional vision lines to process fees related to frames and materials.
The Facets CDH Account Management module automates management of consumer-directed plans. With Facets CDH, you can accurately and cost-effectively manage FSA, HRA and HSA benefit plans. The CDH module provides real-time administration, integrating plan benefits, debit cards and financial institutions in one system. The module also helps you manage consumer funds and integrates with Web-based tools for more effective health and wellness education.
Intelligent Automation for High Volume, High Value Claims Processing
BCBS of La. successfully replaces legacy system with TriZetto Facets core administrative system. Read the impressive results.
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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.