TriZetto Corporation, a company that specializes in healthcare IT solutions, announced on Wednesday that Mutual Assurance Administrators, Inc. (MAA), a multi-site third-party health insurance administrator (TPA) supporting health benefits administration for more than 115,000 member lives, has upgraded to the latest version of TriZetto's QicLink(TM) enterprise core administration system, the Wall Street Journal reports.
The solution is designed to assist administrators in enhance efficiency and effectiveness through greater automation, increased auto-adjudication and reduced manual intervention in claims processing.
The updated 5.00 version of the system supports ICD-10 compliance, providing data load, maintenance and inquiry functionality for TPAs migrating to the expanded diagnosis and procedure code set.
Given that the ICD-9/ICD-10 crosswalk functionality is integrated within the QicLink application, clients such as MAA can perform ICD code translation processing within key functions such as claims adjudication, exception processing and pre-certification case management.
ICD-10 is also incorporated in the company's QicLink-integrated ClaimsExchange(R) electronic connectivity.
Praising the new version of the QicLink platform, MAA has said it believes it will assist clients looking to submit data using the more granular coding.
“With TriZetto's QicLink 5.00 release, we now have streamlined, automated ICD-10 and HIPAA 5010 capabilities," said Jeff Knox, chief technology officer at MAA. "MAA truly is ahead of the game; we're where we need to be to support our clients, capture and use data to drive wellness initiatives and help each customer build a healthier workforce.”
MAA's work in population health management is also supported by the relational database capabilities of the 5.00 version.
The update only took MAA hours to install.
“MAA has effectively employed the relational database functionality to populate its data warehouse and enhance disease management and wellness programs in concert with the TPA's healthcare partners,” said Scott Ray, TriZetto's senior vice president of benefits administration services and application management services. “The relational database capability of TriZetto's QicLink system also supports a more efficient portal, easing MAA's collaboration with its partners on behalf of clients.”
Edited by
Ashley Caputo
