Claims volume, just like your business, constantly changes. Higher volume can place added strain on your staff and resources, while lower volume can lead to costly employee downtime. Running a solid and consistent claims operation can greatly increase efficiency. Your ability to operate in this equilibrium is a key to staying one strategic step ahead of the competition.

TriZetto processes claims for more than 65 customers annually, helping these organizations:

• Achieve cost savings of as much as 40% in claims processing
• Increase procedural accuracy to 99.4%
• Reach financial accuracy of 99.6%
• Decrease overall core administration expense an average of 20%

TriZetto Claims Administration Services include:

• Adjudication with pend resolution
• Adjustment processing/COB
• Claims finalization
• 1099 processing
• Provider and member correspondence

Flexible delivery models– Payers can outsource on an ongoing basis or as needed to complete “on-demand” projects. And payers can choose to outsource pieces of the business or entire business processes.

Flexible sourcing models – With more than 700 professionals, 70% of whom have college degrees, working in onshore and offshore facilities, TriZetto can help meet the scale, scope and cost demands of any payer organization.