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The Web has become a prevalent and cost-effective vehicle for organizations to extend application processing beyond the boundaries of their physical four walls. TriZetto Constituent Web Solutions automate transaction processing and information exchange between a health plan and its external constituents by extending the reach of "core systems" over the Web. TriZetto Constituent Web Solutions are primarily focused on health plan interaction with consumers, providers, employers, and brokers.
As the healthcare industry undergoes historic transformation into a retail-oriented marketplace, TriZetto believes that payers must have four enterprise-class systems: core administration, network management, care management and sales automation and support. These systems must be accessible by consumers, providers, employers, and brokers on a real-time basis over the Web through easy-to-use, integrated user interfaces.
Some examples of common transactions accessible over the Web include:
| Consumer |
Provider |
Employer |
Broker |
• Claim inquiry
• Order ID card
• Provider search
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• Eligibility and benefit inquiry
• Referral and pre-authorization submission
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• Prospective subscription roster
• Display invoice
• Member census
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• Transaction status
• Receipt history
• Billing entities
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TriZetto's Constituent Web Solutions also support your consumer-directed healthcare (CDH) initiatives with Benefit Cost Modeler, a valuable online tool that helps consumers make informed decisions about their healthcare. Treatment Cost Navigator delivers accurate out-of-pocket patient liability and provider/facility costs as consumers may search for conditions, treatments and services, viewing related costs based on their unique benefit plan. TriZetto's Member Benefit Profile provides members an easy-to-read, well-organized and comprehensive view of their own healthcare utilization and remaining benefits. TriZetto's Constituent Web Solutions also support provider transactions. Provider POS Direct delivers real-time information and transaction processing to providers at point-of-service, including patient liability estimation and claims adjudication.
These solutions are fully interoperable with Facets, TriZetto's enterprise-wide core administration solution, ensuring real-time access to information for seamless and accurate transactions.
Benefits
- Simplifies the ability to provide complex e-business transactions over the Internet.
- Allows the real-time externalization of data from Facets or other administrative systems through seamless integration.
- Provides 24x7 access to critical information, enabling your staff to respond effectively to the needs of diverse constituents.
- Supports your CDH strategy by providing online information and tools to customers in an increasingly consumer-oriented market.
- Improves customer satisfaction and staff productivity by decreasing phone calls and allowing customers to perform online self-service.
- Maximizes your long-term investment with one integrated solution from one vendor, not a patchwork of e-business applications and vendors.
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Information
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For more detailed information, please call 1-800-569-1222 or click on the link below.
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