ENABLE SUCCESS
Establish a strong payer core administration platform
Adopt next-generation healthcare payer software solutions to drive growth, increase efficiency, enable compliance and support new business models. TriZetto Facets delivers the claims administration software for health plans that modern payers need to stay competitive.
Facets modular add-ons
Facets Workflow ensures real-time delivery of claims and customer service tasks within your payer claims processing software, minimizing operational bottlenecks and driving faster resolutions. By automating task assignments and routing, Facets Workflow helps health plans improve accuracy, enhance member satisfaction and optimize resource utilization.
Facets Accumulator Synchronization enables near real-time synchronization of member accumulators between the Facets core administration platform and third-party vendors. This seamless data exchange ensures up-to-date benefit balances, improves claims accuracy and enhances member experiences for benefits such as deductibles and out-of-pocket maximums. The solution reduces discrepancies, prevents rework and streamlines coordination across your partner ecosystem.
Whether integrating with care management platforms, provider portals or custom apps, Open Access strengthens payer-provider collaboration platforms by helping health plans unlock real-time insights and streamline workflows across their ecosystems.
Manage shared risk arrangements with confidence using the Facets Assigned Risk Module. Designed for HMO products, this solution supports capitated entities by enabling seamless sharing of financial risk, claims processing and utilization management (UM) responsibilities. Health plans can automate complex risk assignments, enhance transparency with delegated partners and ensure compliance—all within the Facets core administration platform.
Simplify and accelerate dental claims processing with Facets Dental, a fully integrated claims administration software for health plans within the TriZetto Facets core administration platform. It streamlines claims auto adjudication, automates benefit validation and improves provider payment accuracy helping health plans enhance operational efficiency while delivering better experiences for members and dental providers alike.
TriZetto Third Party Administration Solution module has the critical capabilities necessary to efficiently administer self-funded plans.
Pre-built, configurable bots automate time-consuming processes from claims intake to data validation helping health plans improve claims auto adjudication, scale effortlessly and drive faster ROI.
A SaaS-based electronic claim routing and repricing solution that connects payers, TPAs and self-insured employers to a vast PPO network through a single point of connectivity—eliminating manual processes, reducing administrative costs and automating repricing workflows across more than 12 million claims annually.
Facets partners
Facets partners enhance our enterprise solutions with complementary software, services or technology, meeting our quality standards for integration and interaction with Facets technology.
Take the first step
Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital healthcare solutions is vast and growing. Our expertise in healthcare payer software solutions beginning with TriZetto Facets core administration, enable claims auto adjudication, prior authorization automation for payers and payer-provider collaboration solutions that enable us to integrate cutting-edge technology seamlessly into your health plan's operations.
Let’s talk about how our healthcare IT solutions can work for your business.