TriZetto and Edifecs Partner to Help Customers Meet HIPAA 5010 Compliance

GREENWOOD VILLAGE, Colo. - October 21, 2010 - The TriZetto Group, Inc. today announced a partnership with Edifecs, Inc. to embed the Edifecs5010TM Solution into the TriZetto Advantage 10 Compliance PlusTM 5010 service to streamline the mapping of HIPAA 4010 EDI transactions to the new ANSI x12 5010 standard, which has a compliance date of January 1, 2012. TriZetto Advantage 10 Compliance Plus 5010 service provides a single path to help payers meet 5010 compliance with their core administration systems.

"By integrating the Edifecs5010 Solution into our 5010 compliance service, our clients can do their 5010 migration once, with greater confidence that claims will be automatically adjudicated correctly," said Greg Larson, TriZetto's associate vice president of services product management. "Many health plans have been misled to believe that they do not have the time to upgrade their core administration systems to accept 5010 codes directly. But, with the help of TriZetto's Advantage 10 Compliance Plus 5010 service, payers can do both - upgrade their enterprise administration systems and become fully 5010 compliant. The Edifecs5010 Solution provides additional horsepower to the final stage of this 5010 service. Payers can now get ahead of the 5010 compliance curve, and focus more attention on the bigger effort of ICD-10 migration and healthcare reform."

With Level 1 compliance testing beginning in January 2011, health plans must prepare their systems now for new 5010 requirements. TriZetto's Advantage 10 Compliance Plus 5010 service, strengthened with Edifecs' industry-leading 4010A1-5010 translation solution, is optimized for TriZetto customers wherever they may be on their readiness path. The service also enables health plans to assess the business impact (not just technology impact) that 5010 transactions will have on their everyday operations.

For payers, TriZetto's Advantage 10 Compliance Plus 5010 service creates a readiness scorecard for 5010 and ICD-10, a partner cutover strategy, a roadmap, and a resources and tools requirements list. Subsequently, the service defines a high-level business, technology and testing strategy, including developing a baseline 5010 map. TriZetto then defines and customizes the 4010A1 to 5010 translation maps for each trading partner. In the last of the four phases, TriZetto will use the Edifecs5010 Solution to complete the migration.

"The combination of Edifecs' testing and translation solutions for HIPAA 5010 compliance and TriZetto's Advantage 10 Compliance Plus 5010 service brings two best-in-solution technology vendors together," said Piyush Pushkar, vice president of solution consulting at Edifecs. "We are confident that this partnership will deliver unprecedented value to our customers in their efforts to achieve 5010 compliance within budget and on time."

About Edifecs

An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information between health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA 5010 and ICD-10. Today, more than 350 healthcare customers use Edifecs technology to unify transactions from any information channel, while automating manual business processes such as enrollment, claims and payments management.

Edifecs is recognized as one of the 100 Fastest Growing Private Companies in the state of Washington, one of the 100 Best Places to Work for in the state of Washington, and an Inc. 5000 fastest growing companies in the U.S. Edifecs is headquartered in Bellevue, Wash. For more information, please visit

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry, with its technology touching half of the U.S. insured population. TriZetto's vision for the industry, Integrated Healthcare Management, is the optimized coordination of benefits and care for healthcare consumers to improve the value of every healthcare dollar spent. The company's offerings include enterprise and component software, I.T. outsourcing services, business process outsourcing services and consulting that help payers transform and optimize their operations to enhance revenue growth, to drive administrative efficiency and to improve the cost and quality of care.

Media Contacts:

The TriZetto Group
Rachel Tanner Lew
[email protected]

Schwartz Communications
Davida Dinerman or Pauline Louie
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Jamie Gier
425-452-0630 x512
[email protected]