Two BlueCross BlueShield Plans Select TriZetto's Software to Determine Patient Liability and Adjudicate Claims in Real-Time

  
    
  
  
    
      The TriZetto Group Inc. (NASDAQ: TZIX) today announced two new customers 
      for the company’s real-time patient liability 
      and point-of-service claims adjudication software, Provider POS Direct™.
    
    
      Blue Cross and Blue Shield of Kansas City (BCBSKC) and Blue Cross and 
      Blue Shield of Rhode Island (BCBSRI) are the latest health plans 
      embracing the value of real-time claims adjudication by selecting 
      TriZetto’s Provider POS Direct application. 
      BCBSKC has nearly 900,000 members and 4,000 network providers; BCBSRI 
      has more than 680,000 members and nearly 3,900 network providers. 
      Additionally, BlueCross BlueShield of Tennessee last year incorporated 
      the software to serve 2.3 million members and the 75,000 providers in 
      its network.
    
    
      The Provider POS Direct application will be hosted for BCBSRI in a 
      TriZetto data center.
    
    
      The Provider POS Direct software helps payers improve the cost of care 
      with an application that supports providers’ 
      financial operations and improves cost transparency. By automating the 
      delivery of accurate, real-time information to providers, the Provider 
      POS Direct application helps increase payer administrative efficiency 
      and improve member, provider and employer satisfaction.
    
    
      TriZetto’s Provider POS Direct software 
      determines the patient’s financial liability, 
      the provider’s negotiated charge and the 
      health plan’s expected payment at any time -- 
      before, during or after care, enabling providers to collect the patient’s 
      liability when the appointment is scheduled, at check-in or at 
      check-out. The Provider POS Direct application helps improve cash 
      collections, reduce unnecessary billings and minimize bad debt because 
      the application enables real-time and direct access to accurate billing 
      information much earlier in the revenue cycle between the member, 
      provider and payer.
    
    
      “BCBSKC and BCBSRI are shining examples of 
      health plans forging long-term quality relationships with providers,” 
      said Dan Spirek, executive vice president and chief solutions officer 
      for TriZetto. “They are progressive for 
      identifying and implementing software that enables real-time patient 
      liability determination and claims processing.”
    
    
      The Provider POS Direct software can be integrated with provider 
      information systems and core payer administrative systems. The software 
      is built on service-oriented architecture, with Internet browser 
      capability, Web services for HIPAA compliance and ease of 
      interoperability with legacy applications.
    
    
      About TriZetto
    
    
      TriZetto is Powering Integrated Healthcare Management™. 
      With its technology touching nearly half of the U.S. insured population, 
      TriZetto is uniquely positioned to drive the convergence of health 
      benefit administration, care management and constituent engagement. The 
      company provides premier information technology solutions that enable 
      payers and other constituents in the healthcare supply chain to improve 
      the coordination of benefits and care for healthcare consumers. 
      Healthcare payers include national and regional health insurance plans, 
      and benefits administrators that provide transaction services to 
      self-insured employer groups. The company’s 
      payer-focused information technology offerings include enterprise and 
      component software, hosting and business process outsourcing services, 
      and consulting. Headquartered in Newport Beach, Calif., TriZetto can be 
      reached at 949-719-2200 or at www.trizetto.com.