Trizetto Consulting

Our Trizetto® Facets consultants help you leverage the power of the industry-leading software solution for health plan administration. Our subject matter expertise goes beyond claims processing to help you respond quickly and effectively to changes driven by consumer demand, government regulations and medical cost trends.

More about our Facets Consultants

Our Facets consultants, on average have at least 5-7 years of operational experience working with the product. Most also come with 10-20 years of experience in healthcare. They’ve worked as case managers, claims adjusters, and auditors. Many even have past experience as nurses or physicians.

This means that they have the ability to see beyond your immediate need, right down to the core of the business problem you’re trying to solve. You’ll get more than just a technical expert. You’ll receive tested and proven consultants who can hit the ground running on your project.

Leveraging the advanced functionality of Trizetto® Facets for current and emerging business needs, our consultants can help your organization maximize the use of your Facets product in the following areas:

Plan Build and Configuration for Lines of Business:

• Commercial, PPO, HMO, Medicare, Medicaid, Medicare Part D, Customer Directed, Vision, Dental
• CareAdvance®
• Medical Management/Clinical Review
• Testing
• Documentation/Workflow
• Policies and Procedures
• HIPAA Gateway®
• NetworX Pricer®, Core and Modeler®
• Blues: ITS Sub System
• ICD-10 and 5010
• Facets™ Data Dictionary – Mapping and Reporting

TRIZETTO®, Facets™, CareAdvance®, NetworX PRICER® and QNXT™ are trademarks owned by The TriZetto Group, Inc. Blue Eagle Consulting is not affiliated with The TriZetto Group, Inc. and The TriZetto Group, Inc. neither sponsors nor endorses our materials, goods or services.

TRIZETTO® QNXT

QNXT™, TriZetto’s next-generation enterprise application system, helps health plans meet the demands of increasingly diverse healthcare consumers. This award-winning, open platform helps payers adapt to market changes rapidly and efficiently while offering a low total cost of ownership.

With QNXT customers can configure their system to ensure that key decision makers have the right information in real time. The flexible and scalable .NET architecture integrates readily with other systems and add-ons.

QNXT supports medical and dental claim processing as well as advanced HSA/HRA functionality, and offers claim re-pricing and external billing, integrated care management, care planning, predictive modeling, and branching logic.

Utilizing QNXT, we can help your health plan maximize the benefits and capabilities it provides in the following areas:

• Configuration and Plan Build for: Medicare, Medicaid, Medicaid Part D, Consumer Directed, Dental
• Crystal® and SQL Reporting
• Data Mapping and Extracts
• ICD-10 and 5010
• Testing and Quality Assurance
• Medical Management
• CMS Guidelines and Business Rules
• QSCI® and QMACS® Support and Training
• BlueCard™ (ITS)
• EDI – BizTalk®