Winners of the TriZetto 2013 Healthcare Excellence Awards Improve the Effectiveness and Efficiency of the Business of Healthcare

Winners of the TriZetto 2013 Healthcare Excellence Awards Improve the Effectiveness and Efficiency of the Business of Healthcare

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today announced the 2013 recipients of the , who were recognized at the company’s inaugural Healthcare Conference, May 19-22 in Palm Desert, Calif. and ., both received the TriZetto Healthcare Excellence Award for health plans; received the TriZetto Healthcare Excellence Award for third-party administrators (TPAs); and Newport Pediatrics received the TriZetto Healthcare Excellence Award for providers.

The program recognizes healthcare organizations that have used TriZetto solutions and services to improve the efficiency and effectiveness of the business of healthcare. For the 2013 program, TriZetto expanded the awards to include providers and TPAs. In previous years, the program focused on health plans.

“The TriZetto Healthcare Excellence Awards program provides the opportunity to recognize accomplishments our clients have achieved through the use of TriZetto solutions and services,” said TriZetto President and Chief Operating Officer Jude Dieterman, who presented the awards. “This is the fifth year of the awards program, and the fifth year in which we have had the privilege of sharing some remarkable success stories with you.”

Hawaii Medical Service Association (HMSA), the largest health plan in Hawaii, was facing the challenges of migrating from ICD-9 coding to ICD-10 coding. HMSA worked with TriZetto’s Development and Advisory Services professionals on development of the , which automates and accelerates the data-migration process. The company expects to save $1.1 million by using the Toolkit in testing performed in conjunction with the migration.

California-based Molina Healthcareserves nearly 1.8 million individuals and families receiving care through government-funded programs in 9 states. Molina Healthcare leveraged application to complement its provider contracting initiatives in order to better optimize its provider reimbursement approach.

Mutual Assurance Administrators (MAA),an Oklahoma City-based TPA serving 115,000 members, had acquired several other TPA firms and wanted to consolidate them on one system. MAA also wanted to adopt relational database technology and accommodate ICD-10 and 5010 requirements. With support from TriZetto’s project management team, MAA consolidated multiple offices on the application and migrated to .NET-based technology with relational database capabilities. Subsequently, MAA upgraded to QicLink 5.0, which supports ICD-10 and 5010. MAA is now ICD-10-compliant, and positioned to increase automation via 5010 functionality. The relational database capabilities enable MAA to help clients build healthier workforces.

Newport Pediatrics,a medical practice based in Newport, Tenn., participated in a real-time proof-of-concept program. In connection with the program, the medical practice wanted to maintain or improve first-attempt billing accuracy, increase the amount of patient liability collected, and reduce the cost of revenue collection. , used in the proof-of-concept program, enabled Newport Pediatrics’ staff to connect directly to payer systems and determine patient liability before, during, and after treatment for all members of the participating plan. After using the TriZetto solution for just one month, the practice had seen improved patient relations and reported that it anticipates a long-term decrease in billing/statement costs.

The TriZetto Healthcare Conference is one of the industry’s largest forums for healthcare organizations, bringing together health plans, TPAs, health systems and physicians to interact, exchange ideas, attend sessions and visit TriZetto’s solution and partner center to learn about new solutions that can help them achieve their business goals.

Sessions at the conference covered such topics as healthcare reform, payer-provider collaboration, government programs, consumerism, accountable care organizations and other new models of delivery and care.

: Congratulations to the four TriZetto Healthcare Excellence Award winners #efficiency #healthcareIT

TriZetto provides world-class information technology and service solutions that help payers and providers work more efficiently and to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 200,000 care providers. TriZetto helps healthcare organizations ; ; ; and compete to win in an emerging retail market. Payer solutions include , , and portal platforms, as well as , and . Provider solutions include real-time eligibility assurance, claims editing, that help providers get paid quickly and accurately. For more information, visit .


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