TriZetto’s New QNXT Configuration Solution Enables Healthcare Payers To Rapidly Change, Launch Products For Success In Post-Reform Market

TriZetto announced the general availability of an integrated technology solution and advisory service that automates and accelerates ongoing configuration and migration tasks for healthcare payer customers of the company’s QNXT TM core administration system. Some 70 health plans use TriZetto’s QNXT system to administer the benefits of approximately 20 million Americans.

The new QNXT Configuration Solution enhances the ability to configure the QNXT platform for new lines of business, new plan designs, and federal and state mandates. Over the past few months, TriZetto has worked with the Hawaii Medical Service Association (HMSA) to jointly develop the QNXT Configuration Solution.

An independent licensee of the BlueCross and BlueShield Association, HMSA covers more than half of Hawaii’s population and is a longstanding QNXT customer.

“We anticipate TriZetto’s QNXT Configuration Solution will automate workflow and simplify configuration build processes that are manual today. With this solution, we will greatly reduce keying in configuration data as well as the data-entry errors that can happen as a result,” said HMSA senior manager Marsha Magnussen.

“Certainly, health plans choose TriZetto’s QNXT system because it’s a single-system solution that streamlines enrollment, premium billing, claims processing, customer service and other administrative functions,” said Tom Kearns, senior vice president of consulting services at TriZetto. “But they also choose this platform because it offers flexibility and scales to address changing business requirements. The QNXT Configuration Solution helps ensure that our customers can scale fast, frequently and with fewer manual touches.”

With the Affordable Care Act (ACA), HMSA had to modify hundreds of plans to meet federal requirements for preventive screenings and other medical services. The payer also had to stand up more than 30 ACA-compliant gold, silver and bronze plan options for Hawaii’s state benefits Exchange. TriZetto’s new configuration solution should enable HMSA and other healthcare payers to modify current benefit plans and launch new plan designs in hours instead of days, and days instead of weeks.

“We expect TriZetto’s QNXT Configuration Solution to improve our speed-to-market and flexibility, and we need both to efficiently respond to healthcare reform,” said Linda Katagiri, senior vice president for Member Services at HMSA. “The number of reform mandates – today and for the foreseeable future – makes TriZetto’s solution indispensable for HMSA. With the QNXT Configuration Solution, we will be able to deploy full solutions to test environments and test more thoroughly using Claims Test Pro. We can then move those tested solutions to production, ensuring quality, which ultimately leads to happy customers.” 

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