Generally Facets is known
as a claims processing tool. As a matter of fact, it is much more than a claims
processing tool. Facets
is an integrated health care management system designed to handle the complex
requirements of managed care programs.
Facets is an integrated
health care payer administration solution . That is why Facets can be termed as
a One-Stop Service Center for healthcare payer organizations. It is a
comprehensive client/server based system that integrates eligibility, provider
and plan/product data to efficiently process claims, utilization management,
reviews, case management and customer service information. Facets also handles
premium billing, commissions, capitation, and reporting needs. Facets is a modular
system, allowing insurance companies to select components to meet their key
business needs.
New regulatory
requirements such as ACA as well as ongoing Medicare and Medicaid updates
demand flexibility in payers' technology and processes. TriZetto has developed
Facets to provide solutions to all these complex requirements. Facets is
scalable, serving both large and smaller plans. Facets claims processing
tool has given new directions to health insurance industry.
The Facets system
automates and streamlines critical business functions across the enterprise,
including member enrollment, premium billing, claims processing and customer
service, helping payers decrease administrative spending while improving both
healthcare and business outcomes.
