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Facets partners operate in cooperation with the solutions offered in the TriZetto Facets Enterprise line of core administration products and services. These partner organizations have proven their value by delivering complementary software, services or technology that enhances or expands the functionality and effectiveness of the Facets line. The businesses and solutions identified here meet the quality and integrity standards we have established for our partner organizations—allowing integration and/or facilitated interaction with our industry-leading Facets technology.
ClaimsXten is an integrated partner product of Change Healthcare that provides a clinically-based claims payment software solution for payers that want to create and deploy flexible, automated rules to help improve payment accuracy, reduce appeals, and realize medical and administrative savings. The ClaimsXten - Facets® Adapter helps increase administrative efficiency and enables customers the flexibility to process each claim under the specific terms and conditions of each benefit plan.
By correcting inappropriately billed claims, ClaimsXten has saved billions of dollars for the industry1. It:
Beyond auditing, ClaimsXten helps claims get paid correctly the first time with automated, customizable rules that catch wasteful, abusive or claims errors and reduce post-pay resources.
1 Change Healthcare internal data for all ClaimsXten customers over a 12 month period.
OPTUM® CLAIMS EDITING SYSTEM
The OPTUM Claims Editing System, an integrated partner product, is a powerful adjunct to the Facets enterprise core administration system. The Claims Editing System is a transparent open-architecture and rules-based application that provides a commercial and Medicare-compliant Knowledge base of edits and utilizes date-sensitive processing to adjudicate both professional and facility claims. The application includes full customization capabilities for software auditing logic as well as data relationships and has disclosure statements embedded in the solution. The results for payers are streamlined claims-processing workflows, reduced reimbursement errors and improved payment integrity.GO TO PARTNER SITE
The OPTUM® Prospective Payment Systems (PPS) software application, an integrated partner product, maps, groups and prices facility claims to ensure appropriate reimbursement. OPTUM®’s ECMPro™ application integrates with TriZetto®’s NetworX Suite® solution to manage grouping, pricing, editing and mapping for Federal (DRG, APC, ASC, IRF, SNF, CAH, LTCH, IPF, Physician) Prospective Payment Systems (PPS) and more than 20 state and payer specific PPS. Facility (inpatient and outpatient) and professional Medicare PPS, and a number of Medicaid PPS are integrated with NetworX Pricer® to support auto-adjudicated claims processing. Users can also apply the supported Medicare and/or Medicaid PPS to their commercial business processing. The integrated solutions streamline claims-processing workflows to reduce reimbursement errors and improve payment integrity.GO TO PARTNER SITE
Avalon Healthcare Solutions
Avalon Healthcare Solutions is the world’s first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans across the country, covering more than 15 million lives, Avalon is pioneering a new era of value-driven care with its Lab Insights System. The company delivers 7–12% outpatient lab benefit savings and captures, digitizes, and analyzes lab results in real time to provide actionable insights for earlier disease detection, ensure appropriate treatment protocols, and drive down overall cost.
Through Avalon's partnership with Cognizant, TriZetto® Facets® clients can rapidly realize these savings by leveraging the real-time Facets Interface to Avalon.GO TO PARTNER SITE
Zelis™ Healthcare delivers measurable value through our unparalleled claim integrity solutions, operational excellence and healthcare intelligence. Our integrated multiple products and solutions ensure that our clients are obtaining the highest level of savings on each claim through our robust technology and precise processes, enhanced with human expertise. Through our partnership with Cognizant for a near real-time interface to TriZetto’s® Facets™ core administration platform, we ensure that your daily claim process is kept intact, operation rule consistency automation is achieved, and most importantly, near real-time capabilities reduce turnaround time from days/hours to seconds. With the Facets™ interface to Zelis Payment Integrity services, you will also see reduction of loss ratio and increased operational transparency, all of which can lead to substantial savings.GO TO PARTNER SITE
With the industry’s #1 multi-purse benefit debit card platform tightly integrated with the TriZetto Healthcare Products Facets platform, Alegeus enables integrated consumer benefit account management of HSA, FSA, HRA and dependent care accounts. By giving them access to their flexible benefit account balances using a convenient debit card, Alegeus empowers members to better manage their healthcare expenses and to take a more active role in their health and wealth situation.GO TO PARTNER SITE
Zelis™ Payments is a leading healthcare payments technology company dedicated to delivering value via exceptional client experiences. Our solutions facilitate regulatory compliance and streamline the transfer of healthcare payments and data. Through our proprietary integration with Cognizant’s TriZetto® Facets, Zelis Payment’s technology becomes a part of your daily workflow to create a seamless payment process, which improves accuracy and reduces process complexity for significantly improved cost control. To ensure provider satisfaction and reduce noise, we employ a unique, provider-centric enrollment and support model, which encourages electronic adoption and network retention.GO TO PARTNER SITE
RedCard delivers reliable, client branded, enhanced design and production of critical customer communications including healthcare checks, explanation of payments (EOPs), explanation of benefits (EOBs), healthcare (ID) cards, enrollment-related correspondence, and letters delivered in the mail or via the Web. RedCard enables clients, through an integrated set of web-based self-service management tools, the ability to redesign its member and provider communication utilizing the latest four-color technology. Based on client-specific needs, it will also enhance communication time frames using its industry first, healthcare episode-based claim bundling option. This integrated system creates new cost savings while changing the frequency, look, and feel of the communications, allowing for fewer customer service calls and an overall better experience.GO TO PARTNER SITE
If your organization offers solutions that could potentially enhance those offered within Cognizant’s line of TriZetto Healthcare Products and provide added value or an enhanced experience for our payer clients, CLICK HERE. Our Stragetic Alliances Team will work with you to determine if a potential partnership is appropriate.