The TriZetto Group has unveiled its Member Benefit Profile and Treatment Cost Navigator solutions and enhanced the Benefit Cost Modeler.
The three Web-based solutions are designed to enable plan members to make better healthcare decisions by providing real-time, personalized transparency capabilities for benefit decisions, treatment options and related costs and health benefit use.
"Previous member-facing payer solutions were generally fragmented and lacked personalization," said Jeff Cohen, senior director of consumer solutions at TriZetto. "We believe that providing the most accurate cost information that is relevant to a member's benefits will increase member adoption and improve the overall satisfaction with online tools."
TriZetto's new capabilities enable payers to address consumer needs throughout their entire healthcare experience, from plan evaluation and enrollment to managing health and benefits, evaluating care options, accessing care and tracking healthcare and benefit use.
Treatment Cost Navigator delivers treatment cost information to consumers pre-care. The technology uses simple terminology and provides cost calculation based on the member's actual benefits, providing a view of actual member out-of-pocket costs.
Member Benefit Profile provides members with a view of their own healthcare and benefits use, providing access to retrospective information about claims transactions, fund balances and transaction history across multiple member accounts. Members can receive statement notifications via e-mail, thereby streamlining communications, simplifying health and benefit information and ultimately saving health plans the costs to produce and mail traditional explanation of benefits.
New enhancements to Benefit Cost Modeler (BCM) include the ability for members to use the prior year's claims to help model costs as well the ability to examine potential tax savings associated with tax-favored health savings accounts.
All three solutions are integrated with TriZetto core solutions, but are designed so that they may also be deployed on other payer administrative systems.
"As individuals begin to proactively manage their own healthcare information, the impersonal, summarized means of delivering information to consumers is no longer enough to adequately engage and empower consumers," said Dan Spirek, chief solutions officer at TriZetto. "We believe that with the right tools, information and incentives in place, health plans will not only help consumers make better healthcare decisions but also those payers will have a competitive advantage in the market."