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The TriZetto Group Releases New Version of TriZetto's QNXT Enterprise Core Administration Platform
[March 14, 2011]

The TriZetto Group Releases New Version of TriZetto's QNXT Enterprise Core Administration Platform

Mar 14, 2011 (Close-Up Media via COMTEX) -- The TriZetto Group, Inc. announced the general availability of its QNXTTM 4.8 release, the newest version of the company's enterprise core administration system built on the Microsoft .NET platform.

The QNXT solution, which drives claim auto-adjudication rates as high as 90 percent, will help healthcare payer organizations improve efficiency throughout operations in three key areas: compliance, integration, and security and auditing.

QNXT Supports 5010, ICD-10, CORE Certification and Medicare Compliance TriZetto's QNXT solution has supported the new HIPAA 5010 transactions and ICD-10 code set since its 4.7 release in 2010. Expanding on these capabilities, the QNXT 4.8 release includes an interactive mapping utility for 5010 transactions, allowing end users to view the mapping of each 5010 data element and its corresponding QNXT data element.

"The HIPAA 5010 mapping utility is a huge benefit to payers when working with trading partners and their often unique transaction requirements, as well as the nuances of each HIPAA transaction," said Marty Newton, vice president of product management at TriZetto. "Plus, this increased mapping transparency will help health plans accelerate the migration of their 4010 transactions to the new 5010 transactions." Additional compliance capability stems from new CORE phase 1 certification for the 5010 transactions and a roadmap for additional CORE 5010 certification. In addition to its current ability to group and pay Medicare DRGs and APCs, TriZetto's QNXT 4.8 release supports provider reimbursement using the APR-DRG pricing methodology.

QNXT 4.8 Includes New Web Services That Facilitate Third-Party Integration The QNXT 4.8 release is available with TriZetto's new QNXT eXtended IntegrationTM (QXI) set of web services. The web services enable users to integrate multiple information technology applications with the QNXT application.

"The value here is in accelerated system integration, faster speed to market and the ability to leverage previous investments that a payer has made in third-party or homegrown software," Newton explained.

Enhanced Security and Auditing Monitor PHI Data TriZetto's QNXT 4.8 release also debuts an enhanced security and auditing capability for protected health information (PHI). The new functionality allows health plans to track and monitor all users' access to, queries of, views of and changes to PHI and PHI-related data, such as membership, enrollment, claims and utilization management documents. The new functionality also can identify VIPs, or high-profile members, and allows for more stringent security settings for users' access to PHI.

TriZetto's QNXT system is an open platform that helps nearly 60 health plans touching 17 million lives automate and streamline critical business functions such as member enrollment, premium billing, claims processing and customer service.

TriZetto provides 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.

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