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Achieving these goals can be difficult, but automating and integrating as many processes as possible can make meeting them feasible.
Our approach to care management starts with Clinical CareAdvance® and CareAdvance Provider®, solutions that together deliver full care management capabilities across utilization, case and disease management. These solutions transform care management into an automated, data-driven activity that delivers more targeted, effective health information and wellness campaigns. The outcome is improved interactions with members and providers.
Our Value-Based Benefits solution, the second part of our care management portfolio, provides an automated and integrated solution for designing and administering member incentive programs. Our newest care management solution, TriZetto® Touchless Authorization Processing (TTAP), enables fully automated prior authorization via provider portal, including integrated clinical criteria and pre-built integration to QNXT™.
Because our CareAdvance and Value-Based Benefits solutions share a member portal, these solutions can use the same rules. This approach automates your plan’s workflows and leverages real-time coordination between systems. While both are core product-agnostic, each solution can also be fully integrated with both Facets® and QNXT solutions.
Our Care Management solutions helps healthcare organizations enhance revenue growth, drive efficiency and improve cost and quality of care. Your benefits include:
Automated workflows and member-provider outreach
Complete solution for implementing member incentive programs
Integrating utilization management efficiencies into provider workflows
Reduce costs and improve patient experiences with automated authorization
Comprehensive, flexible and scalable core administrative solutions that enable the digital transformation required for success in the commercial market.
Support for the economic advantages and efficiencies.
Flexible IT solutions to address requirements with customizable functionality.
Functionality that adapts to meet the complexities and demands of the Medicare Advantage market.
Functionality that adapts to meet the complexities and demands of the Managed Medicaid market.
Flexible solutions to coordinate multiple compliance requirements and ease administration burdens.