DRIVE INCREASED ITS NETWORK EFFICIENCY

Real-time ITS solutions enable faster, more accurate and cost-effective claims processing and member liability estimations for BCBS plans.

Blue Cross and Blue Shield plans communicate and share data with each other via the nationwide ITS network. But getting a core administrative system to seamlessly share data via ITS can be a challenge. Data input errors, unacceptable time lags, inconsistency and even compliance issues can erode productivity and customer loyalty.

TriZetto's ITS solutions for Facets enable Blues plans to better support real-time claims processing and member liability estimation using the ITS structure. Designed to meet the specific business needs of Blue Cross and Blue Shield organizations, the Facets ITS subsystem allows you to send, receive and manage data regarding claims, providers, membership and fee-for-service/capitation billing.

In the process, it:

• Reduces costly manual processes.
• Delivers quality interactions.
• Enables your organization to manage both “Host” and “Home” claims faster, more easily and more economically.
• Improves provider and member experience through accurate and consistent inter-plan communication.
• Fosters more accurate patient information and real-time liability calculations.
• Enables your organization to meet the Blue Cross and Blue Shield Association (BCBSA) Home Plan member liability estimation requirement.