Sunday, November 13, 2016

What is Facets in health insurance?

Facets can be termed as a One-Stop Service Center for healthcare payer organizations. It is an integrated health care payer administration solution, designed to handle the complex requirements of managed health plans. The role of facets in health insurance is of great importance. 

New regulatory requirements such as ACA as well as ongoing Medicare and Medicaid updates demand flexibility in payer’s technology and processes. TriZetto has developed Facets  to provide solutions to 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.

The current version of Facets is 5.0 and Facets is organized in Application groups and the main  Application groups are as follows:

1. Accounting application group
2. Application Support application group
3. Billing application group
4. Capitation/Risk Allocation application group
5. Claims Processing application group
6. Claims Processing + ITS application group
7. Commission application group
8. Criteria Maintenance application group
9. Customer Service application group
10.  Dental Plan application group
11. Dental Provider Agreement application group
12.FSA Plan application group
13. ITS Application Support application group
14. ITS Plan application group
15. Medical Plan application group
16. NetworX application group
17. Pricing Profile application group
18. Provider application group
19. Subscriber/Member application group
20. Utilization Management application group

6 comments:

  1. Thank you for sharing such great information.
    It is informative, can you help me in finding out more detail on
    Health Insurance Plan.

    ReplyDelete
  2. It would not be wrong to justify the fact that such a blog enhanced with very potential information, would always help an individual and group of companies to learn, understand and make a decision accordingly in their corporate world.
    Apparently I would like to give an overview of my company. We are HRSG “THE ULTIMATE CLOUD SOLUTIONS YOUR COMPANY NEEDS.” We help Multinational Companies to grow and give them a proven record support in “Recruiting, outsourcing, consulting, management software’s and Business solutions, enabling them to become a market leader.
    HRSG Insurance is a brokerage house providing you a one-window solution for all your corporate and individual insurance needs. We represent you, the client, and make sure that we provide a customized solution that matches your insurance requirements. Secure your business with our bespoke insurance solutions and minimize your administrative time and costs with competitive prices and products.

    Insurance Advisers Pakistan

    ReplyDelete
  3. The information you have given in the blog really marvelous and more interesting.

    Health Insurance Expert

    ReplyDelete
  4. Thanks for article. Its really helpful

    ReplyDelete
  5. Great post! I am actually getting ready to across this information, is very helpful my friend. Also great blog here with all of the valuable information you have. Keep up the good work you are doing here.
    Kratom Products

    ReplyDelete
  6. What a good blog you have here. Please update it more often. This topics is my interest. Thank you. . .
    How many 3000mg gummies should I eat?

    ReplyDelete