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TriZetto Healthcare Excellence Award Winners Use Solutions to Innovate and Improve Operations

TriZetto Corporation today announced the winners of the 2014 Healthcare Excellence Awards at its annual Healthcare Conference in San Antonio, Texas, recognizing two payers and one third-party administrator for leveraging TriZetto solutions to advance their business.

BlueCross® BlueShield® of Tennessee (BlueCross), Priority Health and Administrative Concepts, Inc. (ACI) are now among the winners of this prestigious award, which is given to healthcare organizations that have used TriZetto products and services to improve operations efficiency and drive innovation.

BlueCross was recognized for Excellence in Innovation for its groundbreaking member dashboard, extended from its TriZetto FacetsTM and CareAdvance Enterprise® products. With an intent focus on the customer experience, the BlueCross member dashboard includes a revolutionary, scalable desktop interface that provides customer service agents with a comprehensive view of member data and a complete understanding of the relationship with each customer. Members now spend significantly less time on hold waiting for answers and consistently have their questions and concerns addressed on the first call. First call resolution scores have improved by five percent, and the number of applications used by call center agents has been reduced from seven to just two. As the industry shifts to a consumer orientation with the health insurance marketplace, stronger customer relationships will become vital for healthcare companies like BlueCross.

“The dashboard gives us a unique competitive advantage in serving our members,” said David Marckel, vice president, enterprise applications at BlueCross. “It required several innovative ‘first-time’ uses of technology and was made possible by leveraging a combination of TriZetto products for care management, core administration and extended integration.”

The Excellence in Operations award went to Priority Health for leveraging TriZetto’s Agile release process to successfully enter the federal Exchange market in October. Priority Health required a strategic partner and an Exchange-ready solution that would enable it to quickly and cost-effectively enter the market. Priority Health fully embraced TriZetto’s service-oriented architecture approach coupled with smaller, more rapid upgrade cycles. Overall, Priority Health has shown significant cost decreases while improving their ability to meet business demands more quickly.

“TriZetto’s new service-oriented architecture approach to continuous and incremental product delivery has been a key enabler for Priority Health to compete successfully in a new world of healthcare reform,” said Krischa Winright, chief information officer at Priority Health. “We have realized significant improvement in value delivery and cost reduction, including supporting real-time transaction processing, through the accelerated approaches adopted by TriZetto.”

Third-party administrator ACI received the Healthcare Excellence Award for TPAs or Excellence in Operations for its success using TriZetto’s QicLink core administration system, ClaimsExchange and Claim Benefit Cross Reference solutions. ACI needed a comprehensive solution to maintain compliance with the new Affordable Care Act and HIPAA regulations. In addition, efficiency and consistency in its claims processing operations were challenged due to multiple manual processes. With the implementation of TriZetto Solutions, ACI has improved productivity and eliminated several manual processes. On average, there has been a four-day decrease in ACI’s turnaround time for all lines of business associated with TriZetto solutions, enabling the organization to more accurately process 30 percent more claims.

“For years, we have wanted to implement these solutions across the majority of our lines of business. The additional benefit options available across lines of business with QicLink version 4.20 have enabled us to configure benefit designs that can accommodate different policies being sold in the marketplace today,” said Sarah Nantais, benefits administrator for ACI.

The TriZetto Healthcare Conference is one of the industry’s largest forums for healthcare organizations, bringing together health plans, third-party administrators, partners and health systems to interact, exchange ideas, attend product and service sessions and visit TriZetto’s solution and partner showcase.

About TriZetto Corporation

TriZetto Corporation provides world-class information technology and service solutions that help payers and providers work more efficiently and collaborate to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 230,000 care providers. TriZetto helps healthcare organizations enhance administrative efficiency; improve the cost, quality and delivery of care; address compliance; and compete to win in an emerging retail market. Payer solutions include benefits administration, care management, network management and portal platforms, as well as consulting, application management and business management services. Provider solutions include real-time eligibility assurance, claims editing, revenue cycle management technology and services that help providers get paid quickly and accurately. For more information, visit www.trizetto.com.

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