Jun. 8, 2011 (Business Wire) -- The TriZetto Group, Inc. today announced that Cox HealthPlans of Missouri and Leon Medical Centers Health Plans of Florida received the third annual TriZetto Integrated Healthcare Management (IHM) Power Awards in the categories of Operational Excellence and Innovation, respectively. The awards honor pioneering healthcare payer customers that demonstrate tangible success in the pursuit of IHM: the systematic coordination of health benefits and care delivery to provide more value for every healthcare dollar spent. The awards were presented at TriZetto’s annual Payer Conference, held recently in Orlando, Fla.
“Reform is creating dramatic change and huge opportunities for health plans,” said Trace Devanny, chief executive officer of TriZetto. “At TriZetto, we firmly believe that IHM can drive dramatic improvements in both affordability and improved outcomes for the U.S. healthcare system. We congratulate and recognize Cox HealthPlans and Leon Medical Centers Health Plans for achieving outstanding, tangible results in driving efficiencies and improving the cost and quality of care.”
Providing coverage to nearly 45,000 people, Springfield, Mo.-based Cox HealthPlans has teamed with TriZetto to address multiple business challenges. Cox HealthPlans wished to achieve compliance with new regulatory requirements, including HIPAA 5010 and ICD-10, while maintaining high levels of administrative efficiency and member satisfaction and reducing provider telephone calls.
“TriZetto’s QNXTTM enterprise core administration system has put us on the path to timely compliance with regulatory requirements,” said Jeffrey Bond, chief executive officer of Cox HealthPlans. “Integration of the QNXT system with other TriZetto solutions has helped us improve member satisfaction and member care. And we continue to achieve impressive levels of administrative efficiency and accuracy.”
Bond noted that procedural and financial accuracy for claims average 99.5 percent and 99.9 percent, respectively, at Cox HealthPlans. “And we’ve logged 99.01 percent for medical management authorization accuracy and enjoyed a 99.89 percent accuracy rate in quoting benefits for members. These statistics speak for themselves.”
Leon Medical Centers Health Plans, a small Medicare-contracted HMO in the Miami-Dade County area, wanted to implement a highly efficient Medicare-ready core administrative system that would help keep operations both simple and streamlined. The HMO, established in 2005, serves approximately 37,000 members.
“TriZetto’s enterprise core administration system and web-based applications have helped us meet all these needs and more,” said Jennifer Puglisi, vice president of information technology at Leon Medical Centers Health Plans, which is operated by HealthSpring of Florida, Inc. “TriZetto systems and services have helped us sustain our competitively low disenrollment rate of just under 5 percent. Customer complaints, grievances and appeals also have been extraordinarily low, thanks in great part to the automation, efficiency and accuracy delivered by TriZetto technology.”
Other nominees for the TriZetto 2011 IHM Power Awards also reported impressive results, including higher auto-adjudication rates in claims processing as well as reductions in processing errors, pended claims and administrative costs. Several had restructured their provider contracts, which enabled their organizations to run more efficiently, and multiple health plans had enhanced their ability to add new products and improve customer service. Numerous organizations attested to the value of TriZetto Services. These customers had used TriZetto’s hosting to get solutions up and running quickly and reliably and to free internal IT staff to focus on other operational demands. Nominees said configuration and data-model training had been helpful, and several health plans reported that TriZetto had assisted them in supporting new business.
TriZetto provides world-class healthcare IT software and service solutions, including patented and patent-pending innovations, that drive administrative efficiency, improve the cost and quality of care, and increase payer and provider collaboration and connectivity. TriZetto’s solutions touch half of the U.S. insured population and reach more than 21,000 physician practices representing more than 75,000 practitioners. The company’s payer offerings include enterprise and component software, application hosting and management, business process outsourcing services and consulting that help transform and optimize operations. TriZetto’s provider offerings through Gateway EDI, a wholly owned subsidiary, include advanced tools and proactive services to monitor, catch and fix claims issues before they can impact a practice. TriZetto’s integrated payer-provider platform will enable the deployment of promising new models of post-reform healthcare.
TriZetto is committed to the integration and convergence of technology systems that enable its vision of Integrated Healthcare Management, the coordination of benefits and healthcare to drive more value from every healthcare dollar spent. For more information, visit www.trizetto.com.