Mutual Assurance Administrators Upgrades in Just Hours to TriZetto’s TPA Solution for ICD-10 Readiness

Mutual Assurance Administrators Upgrades in Just Hours to TriZetto’s TPA Solution for ICD-10 Readiness

<0> Schwartz MSL BostonDavida Dinerman/Maggie Fairchild, 781-684-0770orTriZetto CorporationLoren Finkelstein, 303-542-2460 </0>

today announced that a multi-site (TPA) supporting health benefits administration for more than 115,000 member lives, has upgraded to the new version of TriZetto’s enterprise

TriZetto’s QicLink solution helps benefit administrators increase administrative efficiency and effectiveness through greater automation, increased auto-adjudication and reduced manual intervention in claims processing. The new 5.00 version of the system supports compliance, providing data load, maintenance and inquiry functionality for TPAs migrating to the greatly expanded diagnosis and procedure code set. Because the ICD-9/ICD-10 crosswalk functionality is integrated within the QicLink application, clients such as MAA are able to perform ICD code translation processing within key functions such as claims adjudication, exception processing and pre-certification case management. ICD-10 functionality also is incorporated in the company’s QicLink-integrated ClaimsExchange electronic connectivity service.

Oklahoma City-based MAA says the new version of the QicLink platform will benefit clients in other ways, as well, as providers and partners begin to submit data using the more granular coding.

“With TriZetto’s QicLink 5.00 release, we now have streamlined, automated ICD-10 and HIPAA 5010 capabilities,” said Jeff Knox, chief technology officer at MAA. “MAA truly is ahead of the game; we’re where we need to be to support our clients, capture and use data to drive wellness initiatives and help each customer build a healthier workforce.”

MAA’s initiatives in population health management also are bolstered by the relational database capabilities of the 5.00 and earlier versions of TriZetto’s solution.

“MAA has effectively employed the relational database functionality to populate its data warehouse and enhance disease management and wellness programs in concert with the TPA’s healthcare partners,” said Scott Ray, TriZetto’s senior vice president of benefits administration services and application management services. “The relational database capability of TriZetto’s QicLink system also supports a more efficient portal, easing MAA’s collaboration with its partners on behalf of clients.”

Completed in just hours, the upgrade to TriZetto’s QicLink 5.00 version consolidated the systems of three offices onto a single data center site in MAA’s Oklahoma City offices. “I could not have asked for more from TriZetto; we worked together to complete this major upgrade while maintaining strong client satisfaction,” said Knox. “The upgrade was completely transparent to our customers.

“MAA has been a TriZetto [and RIMS] client since early 1984,” Knox added. “Reflecting back, I think it is saying something that we have been able to make this partnership work successfully for so long.”

The 5.00 release of TriZetto’s QicLink enterprise solution enables clients with its clinical-editing module to define edits by network. This capability allows benefit administrators to apply different rules and actions for specific in-network claims than those for other in-network and out-of-network claims. Additionally, the 5.00 version offers a consumer-directed healthcare module that requires no adapter hardware or software to enable real-time web service requests and responses.

Mutual Assurance Administrators upgrade to TriZetto’s QicLink 5.00 to increase efficiency and #ICD-10 compliance. #healthcare

Mutual Assurance Administrators, Inc. (MAA) is a full-service third-party administrator providing services for self-funded employers throughout the United States. Founded in 1975, MAA is headquartered in Oklahoma City, with full-service operations located in Bartlesville, Okla.; Springfield, Mo.; Little Rock, Ark.; Memphis, Tenn.; and Dallas. We are one of the few TPAs in the nation to offer both medical administration and disability management administration (i.e., workers compensation). As one of the nation’s leading TPAs, our flexible approach to benefits management allows our clients to establish the best possible programs to meet their specific needs.

We provide advanced tools and services to control costs and assist members in making informed decisions. Our clients, brokers and consultants are equipped with meaningful analytics through programs such as Benefit Informatics and Thompson Medstat. These tools allow MAA to provide integrated reporting, predictive modeling and plan modeling, along with clinical and financial benchmarking. As a result, our clients are better prepared to construct strategic long-term plans with confidence.

Our core competencies include:Medical Claims AdministrationMedical Management and Utilization Review (URAC Accredited)GASB 45 Administration and Actuarial ServicesWorker Compensation (Disability Management) AdministrationPharmacy Benefit AdministrationCOBRA AdministrationFSA AdministrationDental AdministrationShort-Term Disability AdministrationWellness and Disease Management Programs

Our goal is to be the undisputed leader in our industry by maintaining diligence in controlling our clients’ costs and providing superior customer service. Our dedicated team-based approach provides outstanding support to our employers, brokers and consultants. We are flexible, responsive and make our clients’ priorities our priorities.

TriZetto delivers world-class information solutions that enable healthcare organizations to work more efficiently and to deliver better health. Its solutions reach 200,000 care providers, streamline processes for more than 360 payers and touch over half the U.S. insured population. TriZetto solutions help increase , , and succeed in the retail healthcare market. Its solutions help and execute strategies for . TriZetto’s healthcare experience, innovative solutions and comprehensive services help simplify healthcare for everyone. For more information, visit .

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