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A highly effective adjunct to traditional customer service models, portal technology-based Member Solutions enable 24/7 access to key plan data and self-service tools. These solutions provide access to information on plan utilization and coverage, medical history, and treatment cost comparison. The health plan enjoys increased member engagement and satisfaction while reducing administrative expense.
TriZetto® Member Benefit Profile™ helps members understand their benefits by providing extensive self-management and self-review capabilities. Easy-to-read, well-organized and comprehensive views show healthcare utilization and applied benefits coverage. Members can access retrospective information on fund balances and transaction histories across accounts, including HRAs and FSAs. They can also get personalized answers to common queries regarding amount spent on claims, amount remaining before deductible is met, status of pre-authorized services and more.
TriZetto® Member Service™ provides web-based tools that allow members to look up information and perform routine transactions from any location at any time. Members can quickly access information on eligibility, claim status, student and handicap coverage, benefits summaries, providers, facilities and more. Members are also able to update primary care physician, address and other demographic information. A highly flexible, scalable and open architecture supports ease of integration with existing web and portal initiatives, as well as other applications, with deployment on a variety of hardware, operating systems and application server platforms.
TriZetto® Treatment Cost Navigator® allows members to obtain estimates of potential out-of-pocket costs for particular treatments. Regional, as well as provider-specific pricing information for both medical and dental treatment comparison is provided utilizing real-time benefit and provider cost data to deliver accurate, personalized results. With this information, members can make more intelligent decisions regarding their healthcare, while effectively budgeting for treatment expenses.