CareFirst BlueCross BlueShield Drives Greater Efficiency with TriZetto’s Administrative, Network and Web Applications

2009 MAY 25 - (NewsRx.com) -- The TriZetto Group, Inc. announced that in just 10 months CareFirst BlueCross BlueShield (CareFirst) has implemented its Facets® 4.51 core benefits administration system and gone live with its Facets WorkflowTM, FXI, customer service and billing automation applications (see also TriZetto).

A joint CareFirst-TriZetto team consolidated two legacy platforms into TriZetto’s Facets system and is migrating 1.3 million mid-market employer group and individual policy members to the upgraded platform through December 2010. CareFirst members will move to the Facets system on their contract renewal dates, or anniversaries.

A customer of TriZetto’s Facets 4.31 system version, CareFirst last year signed a perpetual software, maintenance and services contract to implement the Facets 4.51 platform and the healthcare IT firm’s NetworX Modeler® application and Constituent Web Solutions. These remaining implementations, which are in early planning stages, will further enhance the capabilities and cost-competitiveness of CareFirst’s commercial line of business.

The eventual implementation of TriZetto’s NetworX Modeler system, which forecasts costs to help payers negotiate win-win provider contracts, will complement CareFirst’s use of TriZetto’s NetworX Pricer® application, which automates claims pricing to enhance the efficiency of contract administration.

TriZetto Services, an operating unit of TriZetto, helps CareFirst and other healthcare payer organizations implement, manage and optimize their applications to reduce operational risk while accelerating the development of new products, new businesses and a new focus on Integrated Healthcare Management. CareFirst is the largest healthcare insurer in the Mid-Atlantic region, serving nearly 3.3 million individual and group members.

“With the healthcare market only becoming more and more cost- and services-competitive, CareFirst has invested in technology to expand the services we provide our employer customers and members,” said Chet Burrell, president and chief executive officer of CareFirst. “TriZetto has been an important partner for us, with proven technologies, reliable implementation services and a shared commitment to help improve healthcare outcomes for our members.

“I’m very impressed by how CareFirst and TriZetto staff functioned as a single team throughout the planning and implementation and, particularly, during the critical go-live weekend,” added Burrell. “The integration of multiple systems went smoothly and allows us to further improve the ease of doing business with CareFirst – for medical practices, for hospitals, for employer customers and for our members.”

“CareFirst’s commitment to integrated benefits administration, care management and constituent engagement is a validation, we believe, of Integrated Healthcare Management: the systematic application of processes and shared information to optimize the coordination of benefits and care for healthcare consumers,” said Jeff Margolis, TriZetto’s chairman and chief executive officer. “This Facets system implementation has been an especially great success, and TriZetto is pleased to partner with CareFirst in completing the member migration and remaining application go-lives.”

During the Facets system implementation, the TriZetto services team conducted planning, business analysis and requirements gathering for plan, product and benefit configuration. Additionally, TriZetto designed, developed and implemented data integration connections and interfaces; provided support for integration, regression, end-to-end and performance testing; migrated legacy data; and trained CareFirst’s IT staff.

Over the critical go-live weekend, the TriZetto Services team ensured the necessary code was deployed in the appropriate environments and desktops and that users were ready for the go-live. The team helped CareFirst staff test their access and refine configuration. Throughout the weekend, CareFirst and TriZetto staffed a command center to monitor and manage progress as well as quickly resolve issues. About CareFirst BlueCross BlueShield In its 72nd year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit healthcare organization which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to nearly 3.4 million individuals and groups in northern Virginia, the District of Columbia and Maryland. Through its CareFirst Commitment initiative and other public mission activities, CareFirst supports efforts to increase the accessibility, affordability, safety and quality of healthcare throughout its market areas. About TriZetto Founded in 1997, TriZetto is a privately held healthcare information technology company. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare Management™. TriZetto provides information technology solutions that enable health insurance payers and other constituents in the healthcare supply chain to improve the coordination of benefits and care for healthcare consumers. The company’s offerings include enterprise and component software, hosting and business process outsourcing services, and consulting.