TriZetto Front-End Services alleviate administrative headaches that can add to your costs. Many payers have succeeded in moving most of their claims submissions to electronic format, but a significant ongoing expense lies in getting paper claims submissions into an EDI 837 file that the claims administration system will accept or manually keying in each claim, a costly alternative.

TriZetto solves the problem by delivering 100 percent of claims submissions digitally, enabling you to:

• Achieve higher auto-adjudication and first-pass rates
• Reduce claims rework and turnaround time
• Reduce paper-related costs and make important documents easily accessible online

TriZetto Front-End Services include:

• Mailroom processing
• Imaging
• Paper claim data entry via OCR
• Electronic claims and enrollment
• Member and provider matching
• PPO routing
• EDI to image processing
• Image storage and retrieval

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