The TriZetto Group, Inc., a provider of healthcare IT software and service solutions announced the availability of its TriZetto Advantage 10 Payment AnalytiX solution.
The solution is noted as a SaaS offering that can help healthcare payer organizations maintain financial neutrality between claims coded in ICD-9 or ICD-10. It can help health plans reduce the scope and therefore cost of their ICD-10 migrations significantly.
ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use. ICD-10 is the latest in the classification.
“This new solution can minimize a health plan’s risk of migrating to ICD-10 and the impact ICD-10 can have on its financials, as well as provider relationships,” Scott Hampel, vice president of product management at TriZetto said in a press release.
“The TriZetto Advantage 10 Payment AnalytiX solution can be extremely beneficial to payers in helping ensure that they experience minimal variance in what they pay for claims coded in ICD-10 versus ICD-9. Without this analysis, payers risk an increase or decrease in claims payments to providers, a provider-satisfaction problem and greater administrative costs because more claims payments could fail to process automatically,” Hampel added.
Through this announcement, TriZetto is said to be aiming to position well in the industry as the first company to provide end-to-end ICD-10 solutions that cover the technical, business and clinical impacts needed to comply with and leverage the ICD-10 code mandate by October 2013.
TriZetto’s end-to-end ICD-10 solutions include ICD-10-ready applications for core administration, care management and web portals; applications that complete the ICD-9 to ICD-10 translation; and services that help payers migrate and leverage ICD-10 data. It integrates code mapping, a translation tool, modeling and analytic tools, along with services; to enable health plans to identify the ICD-9 codes they pay against currently, and determine how those payments will be affected by the expanded coding of ICD-10.
The TriZetto Advantage 10 Payment AnalytiX solution is said to enable payers to begin with data analysis and move easily through mapping, pricing and iterative analysis. The integrated solution allows stakeholders throughout payer organizations to make informed decisions about how to minimize the impacts of the new codes across their claims-reimbursement processes, provider-negotiation strategies and medical policies.
Recently TMC reported on the survey results released by The TriZetto Group which indicated that 93 percent of healthcare payers have chosen an approach for their core administration ICD-10 migration efforts, up from 75 percent in the third quarter of 2009, and that 86 percent of health plans are most concerned that providers will be unprepared for ICD-10 compliance and technically unable to submit claims using ICD-10 codes.
Jai C.S. is a contributing editor for HealthTechZone. To read more of Jai's articles, please visit his columnist page.Edited by
Rich Steeves
