BlueCross BlueShield of Tennessee Benefits from Real-Time Financial Settlement with TriZetto's Provider POS Direct
23 February 2007
NEWPORT BEACH, Calif., BUSINESS WIRE The TriZetto Group Inc. (NASDAQ: TZIX) announced that customer BlueCross BlueShield of Tennessee is already benefiting from its initial launch of TriZetto's real-time patient liability and point-of-service claims adjudication software, Provider POS Direct(TM). The health plan has installed Provider POS Direct in two of five pilot provider offices. The health plan expects to complete the rollout of the technology to the remaining three pilot offices by the end of the first quarter. BlueCross BlueShield of Tennessee serves 2.3 million members and is the largest insurer in the state.
According to Chris Levan, CIO for BlueCross BlueShield of Tennessee, the initial rollout of the technology is going extremely well.
"Both our health plan staff and the first group of providers using the technology have all offered very positive feedback about the benefits and value of TriZetto's Provider POS Direct," said Levan. "By using the technology for BlueCross BlueShield members, the doctors now have accurate patient liability at more points in the workflow, from scheduling to check-out. They have been able to collect from the patient at the point of care, and conduct financial settlement at check-out, based on the correct patient liability amount, reducing or eliminating the need for balance billing and cutting administrative costs associated with collecting money on the back end. We're very optimistic about the technology's long-term potential. We've already seen additional demand for this technology from other providers in our network." document.write('');
The capabilities of Provider POS Direct can also greatly benefit members enrolled in consumer-directed or high-deductible health plans.
Added Levan, "By arming these consumers with the exact amount they'll owe out of their own pocket for a particular treatment, we can help our members make better choices about their care, a primary goal of BlueCross BlueShield of Tennessee."
Fully integrated with the Facets(R) administrative system that BlueCross BlueShield of Tennessee has used since 1996, Provider POS Direct can help provide price transparency for patients and providers via real-time access to medical benefit and procedure information in order to determine covered benefits and the exact provider reimbursement due from both the member and health plan.
"Determining the accurate amount a patient owes for their healthcare services - in real-time and at the point of service - is driving some of the most profound changes in the U.S. healthcare system seen over the past several decades," said Dan Spirek, chief solutions officer for TriZetto. "TriZetto is committed to providing our payer customers with the full scope of cutting-edge technology they need to thrive in this new world of retail healthcare, and Provider POS Direct is one critically important way we're delivering on that promise."
As part of this commitment, Spirek also reiterated TriZetto's drive to provide technology for healthcare cost transparency.
"Cost transparency depends on a comprehensive consumer-retail platform that integrates directly with the health plan's claim system, to enable providers and members to determine exact costs," continued Spirek. "This platform also needs to provide consumers with round-the-clock access to the actual costs for various treatments and providers, while enabling the exchange of clinical information via personal health records. TriZetto is distinguishing itself in the payer market by developing the complete set of technologies for health plans to address the increasingly complex needs of its constituents."
About TriZetto's Provider POS Direct
Providers can use Provider POS Direct via a portal on the health plan's Website to access the health plan's administrative system, determine exactly what amount the patient will owe, and then make arrangements to collect the payment. For health plans and providers who prefer direct system connectivity, the solution architecture has been designed to support system-to-system transaction processing. Provider POS Direct is built on an advanced service oriented architecture (SOA), making it easy for customers to integrate the solution into complex IT environments.
Provider POS Direct enables healthcare providers to determine and share with patients the exact cost of a procedure either in advance of treatment, at the time of scheduling, or after the patient has received care, when the actual claim is available for processing. Unlike other vendors whose capabilities rely on replicated data and provide only approximations of costs, TriZetto's Provider POS Direct is the first commercially available solution that provides real-time access to the exact benefit and payment information in the health-plan administrative system that ultimately pays the claims. This real-time access allows the delivery of accurate patient and health plan costs, as well the option of real-time financial settlement among the patient, provider and health plan before the patient leaves the provider's office, which can increase satisfaction and reduced administrative expense. Members can leave the office without worrying about additional paperwork, eliminating the need for the provider to generate bills for the health plan, or mail paper bills to the member.
About TriZetto
With its technology touching nearly half of the U.S. insured population, TriZetto is distinctly focused on accelerating the ability of healthcare payers to lead the industry's transformation to consumer-retail healthcare. The company provides premier information technology solutions that enhance its customers' revenue growth, increase their administrative efficiency and improve the cost and quality of care for their members. Healthcare payers include national and regional health insurance plans, and benefits administrators that provide transaction services to self-insured employer groups. The company's broad array of 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.
Important Notice Regarding Forward-Looking Statements
This press release contains forward-looking statements that involve risks and uncertainties. The forward-looking statements are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may include statements about future revenue, profits, cash flows and financial results, the market for TriZetto's services, future service offerings, industry trends, client and partner relationships, TriZetto's operational capabilities, future financial structure, uses of cash or proposed transactions. Actual results may differ materially from those stated in any forward-looking statements based on a number of factors, including the effectiveness of TriZetto's implementation of its business plan, the market's acceptance of TriZetto's new and existing products and services, the timing of new bookings, risks associated with management of growth, reliance on third parties to supply key components of TriZetto's services, attraction and retention of employees, variability of quarterly operating results, competitive factors, risks associated with acquisitions, changes in demand for third party products or solutions which form the basis of TriZetto's service and product offerings, financial stability of our customers, the ability of TriZetto to meet its contractual obligations to customers, including service level and disaster recovery commitments, changes in government laws and regulations and risks associated with rapidly changing technology, as well as the other risks identified in TriZetto's SEC filings, including, but not limited to, its annual report on Form 10-K and quarterly reports on Form 10-Q, copies of which may be obtained by contacting TriZetto's Investor Relations department at 949-719-2225 or at TriZetto's web site at www.trizetto.com. All information in this release is as of February 22, 2007. TriZetto undertakes no duty to update any forward-looking statement to conform the statement to actual results or changes in the company's expectations.
Contacts: The TriZetto Group Inc. Investor Contact: Brad Samson, 949-719-2220 brad.samson@trizetto.com or Media Contact: Audrey McDill, 303-495-7197 audrey.mcdill@trizetto.com
Copyright Business Wire 2006. All Rights Reserved
Source: dmnnewswire
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