NEWPORT BEACH, Calif. - November 18, 2009 - The TriZetto Group, Inc. today announced the general availability of its Real-Time Inter-plan Teleprocessing Services (ITS), a claims management solution that enables Blues health plans to communicate members' financial liability to one another within seconds.

TriZetto's Real-Time ITS helps Blues plans meet the Blue Cross Blue Shield Association (BCBSA) member-liability-estimation requirements that have a late-2010 compliance deadline. Under these requirements, each Blues plan must be able to respond in real time to other Blues plans that request eligibility and coverage information for members who are treated outside their home service areas.

"Health plans, providers and consumers expect to process claims and determine patient liability quickly," explained Kathy Wiley, TriZetto's vice president of product management. "However, collecting out-of-area member information has been a painstaking, time-consuming process. With TriZetto's Real-Time ITS, this information is now available with a click of a button, so one Blues plan can respond to another and to the treating provider in real time."

When a doctor in Tennessee treats a patient from a California Blues plan, for example, TriZetto's Real-Time ITS tells the doctor's office staff how much the plan and patient each must pay for that office visit or medical service. When the provider enters the information for the service, the Tennessee Blues plan communicates to the California Blues plan through Real-Time ITS and BCBSA software to confirm the patient's eligibility and coverage information. The Tennessee Blues organization then prices the claim at its negotiated rate and notifies the doctor's office. The entire process takes only seconds.

"Several Blues organizations have used TriZetto's Provider POS Direct application to enable providers to determine, in real time, plan and patient liability for members in their own service areas," Wiley said. "Now, with TriZetto's Real-Time ITS, Blues organizations can enable a medical practice in one state that treats patients from Blues plans elsewhere to determine their financial liability immediately. TriZetto's Real-Time ITS is a win-win for providers, health plans and consumers."

This real-time claims management product enables another step toward Integrated Healthcare Management (IHM) by Blues organizations across the country, by increasing the flow of information and aligning incentives. IHM is the systematic application of processes, shared information and aligned incentives to optimize the coordination of benefits and care for the healthcare consumer.

"TriZetto is a dedicated partner to Blues organizations in helping them achieve real-time claims processing between plans," added Wiley. "We've worked closely with a number of Blues organizations and the BCBSA to build Real-Time ITS to satisfy the unique requirements of the association. TriZetto's Real-Time ITS will help ensure accurate liability and claims submissions and improve the provider and member experience through accurate communication, reduced administrative costs and increased productivity."

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare ManagementTM, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

MEDIA CONTACTS:

Loren Finkelstein
The TriZetto Group
303-542-2460
loren.finkelstein@trizetto.com

Melissa Bruno
Schwartz Communications
781-684-0770
trizetto@schwartz-pr.com