Monitors value-based program results in detail.Identifies ROI and contracting opportunities by modeling proposed episodic contracts with robust analytics.Speeds implementation and lowers the cost of upkeep through pre-integration with Facets, QNXT and NetworX Pricer for real-time processing, including prospective bundled payment pricing.Administers both prospective and retrospective bundled payment contracts in real time, during the claims adjudication workflow.Automates episode-based payment bundling contracts in any core claims administration system.Working in real time, during the claims adjudication workflow, and the solution also identifies quality and efficiency indicators. The solution integrates with Facets®, QNXT™ and non-TriZetto core administration systems to aggregate and price bundles used in value-based contracting.
It can help improve the cost and quality of care while enhancing payer/provider relations with efficient reimbursement. NetworX Payment Bundling Administration (PBA) is value-based reimbursement software that enables payers to develop and administer highly automated prospective and retrospective payment bundling programs. Our TriZetto® bundled payments solution addresses these challenges. However, transforming existing fee-for-service claims into episodic-based payments can add significant administrative burden and cost. Bundling payments based on episodes of care can help reduce unwarranted variations and more accurately predict medical costs. Value-based reimbursement models are rapidly gaining prominence as payers look to reward the value, not the volume, of care delivered. Payment bundling platform uses clinical logic to identify and reprice claims based on episodes of care
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