How TriZetto® Facets® Simplifies Your Health Plan Operations | Cognizant


My name is LaRhonda Leonard. I am the
Vice President of IT Claims and Customer Care Systems at Excelis Blue Cross
Blue Shield. We support all lines of business; we are headquartered in
Rochester, New York and we employ about 5,000 employees and we insure about 1.5
million lines. So we’ve been partners with Cognizant for about 10 years. They
initially started with us when we were working on our medical transformation to
move all of our medical business on to Facets and off of our mainframe
systems and since then we’ve partnered with them on various strategic projects
and maintenance of business initiatives. We chose the Facets dental module and we also purchased their real-time claims services. The transformation was very
successful. We did it over a period of 17 months and in most of the data
migrations we had about 99% accuracy in the migration data if not more in some
cases. With the migration we were able to put our dental business on a modern
platform which meant we were able to provide features to our customers as far
as being able to view some of their dental benefits on the web which they
didn’t have before. They were also able to get a single bill with both their
medical and dental information which they had not been able to do before and
we also increased our provider satisfaction by allowing them to
continue to have the feature of real-time claims adjudication with a
more modern technology as well as receiving one remit for both their
medical and dental services for the plan. The major benefits that we received with migrating
our dental membership on to Facets was one…supporting our strategic initiative
of retiring the mainframe. It’s also putting us in a great position to
achieve another strategic initiative which is to grow our dental business. We
received a 20% increase in our first pass rate. So one that’s going to help
our claims area because there’s less spends that they’re gonna have to
manage. It’s also going to improve our provider satisfaction because again
we’re paying more of their claims, the first time around and then it also just
decreases our overall operational costs. you

Add a Comment

Your email address will not be published. Required fields are marked *