TriZetto Healthcare Products / Services/Benefits Administration
Focus on client-facing core competencies, while your IT infrastructure and application management functions are expertly maintained. Gain guaranteed performance; an optimized infrastructure; and hosting and management expertise in support of your QicLink™ core administration system and other critical applications—all for a cost-predictable monthly fee.
Improve operational effectiveness and respond to changing benefits administration requirements with a full complement of technology and administrative service solutions. Select as many or as few services as are right for your organization. Then, choose whether you would like our professionals to fully manage and operate the service or provide connectivity to your team—all within a highly secure, HIPAA-compliant environment.
- Claims data intake services: These services provide mailroom, scanning/OCR, data entry and correction, and EDI claims intake support that will free up your team for client facing business processes.
- Claims adjudication services: Offload labor-intensive claims adjudication, claims payment adjustments, plan building and provider maintenance functions to qualified professionals.
- Claims overflow services: Accommodate those instances where your in-house team is temporarily overburdened and you are in an overflow situation. Highly qualified personnel can help you manage backlog, cover vacation time, relieve overtime situations, quickly implement new accounts and provide additional support during open enrollment.
- Claims continuity services: In the event of a disaster, get back to faster with claims continuity services that cover more than annual recovery testing and off-site storage. Trained QicLink™ claims processors can perform those functions critical to your business using your own policies and procedures. Client, member and provider satisfaction will be maintained while you get your business back up and running.
- Customer service: Member and provider calls can tie up resources. Our trained customer service professionals are available to deliver support 24/7, aided by Constituent Web Portal and Interactive Voice Response (IVR) technology that can be integrated with your TriZetto QicLink™ application.
Optimize the value of your TriZetto QicLink™ core administration solutions. Consultants with both product and healthcare industry experience can help you realize quantifiable gains in productivity, profitability and client satisfaction. Optimize the return on your IT investment and leverage your system's capabilities with one or more of the following:
- Custom programming services to produce specialized formats, views and reports, or create new functionality.
- Training services to ensure your staff is deriving full value from your technology.
- Implementation and integration services to drive a successful, efficient system implementation and integration of pre-existing data and/or third party tools.
- Business performance services for full utilization of current system functionality and improvements in automation, connectivity and web-enablement.