DENVER – May 15, 2012 – The TriZetto Group, Inc., today announced that its wholly owned subsidiary, Gateway EDI, has acquired NHXS, a software company that helps medical practices manage physician reimbursement and minimize the administrative cost of recovering lost revenues. With a client base of 20,000 providers, Sacramento-based NHXS’s capabilities will be integrated into Gateway EDI’s solutions, which include EDI and revenue cycle management services for more than 100,000 physicians.
“NHXS’s solution suite augments our current solutions for medical offices,” said Trace Devanny, chairman and CEO of TriZetto. “Its offerings help group practices obtain accurate claim payments, recover underpayments and free up more time to provide medical care for patients. NHXS’s offerings benefit healthcare payers, as well, by reducing the number of appeals and administrative expenses associated with claim corrections and reprocessing. The addition of NHXS is one more step by TriZetto toward an integrated, real-time provider-payer technology platform that helps physicians and health plans achieve higher levels of efficiency and productivity and lays the foundation for improved clinical communications.”
TriZetto provides world-class information technology and service solutions that help providers and payers work more efficiently and collaborate to deliver better health. The acquisition further expands TriZetto’s combined provider-payer footprint, the industry’s largest. NHXS’s CEO is excited about the short- and long-term benefits of the union with TriZetto.
“In the short term, TriZetto’s and Gateway EDI’s solutions will enhance our offerings and our ability to serve the needs of today’s medical offices,” said Mark Reiger, CEO of NHXS. “Long-term, as part of TriZetto, we have an opportunity to play a larger role – to help the healthcare industry move beyond the acrimony that too often has characterized provider-payer relations and improve both the cost and quality of care delivery in our country.”
NHXS has worked with Gateway EDI since 2009, when the organizations jointly developed the Reimbursement Manager tool, which makes it easier for providers to identify payment inaccuracies. The tool finds such errors and automates the appeal/reconsideration process.
“On average, 4 to 10 percent of claims are incorrectly paid. Working in partnership with NHXS, we’ve helped providers identify inaccurate payments and reduce the time and effort required to get the payments corrected,” said Charlotte Martin, president and COO of Gateway EDI. “We look forward to the new offerings our joint teams will be able to bring our clients.”
NHXS’s current leadership team will continue to run the organization’s day-to-day operations.
NHXS is a leading provider of contract compliance and point-of-service adjudication workflow automation. Built around a robust claims pricing and payer business rules engine, NHXS has made it practical to check every line on every claim for payment accuracy and to calculate patient responsibility at the point of service. NHXS provides the business intelligence for the AMA’s National Health Insurer Report Card. For more information, visit http://www.nhxs.com/.
About Gateway EDI
More than 100,000 providers trust Gateway EDI’s advanced claims management tools and proactive team members to simplify the complex revenue management process. The company helps medical practices maximize revenue by securing accurate reimbursements, decreasing claims rejections and improving payment turnaround times. Gateway EDI’s services include electronic claims processing, real-time verification of a patient’s insurance eligibility, point and click access to identify and recover missing revenue, automated secondary claims and electronic remittance advice and tools that ease patient payment collection. For more information on Gateway EDI, a wholly owned subsidiary of TriZetto, visit http://www.gatewayedi.com/.
TriZetto provides world-class information technology and service solutions that help payers and providers work more efficiently and collaborate to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 100,000 care providers. TriZetto helps healthcare organizations achieve compliance; enhance administrative efficiency; improve the cost, quality and delivery of care; and compete to win in an emerging retail market. Payer solutions include benefits administration, care management, network management and portal platforms, as well as consulting, application management and business management services. Provider solutions include real-time eligibility assurance and claims editing and revenue cycle management technology and services that help providers get paid quickly and accurately. For more information, visit www.trizetto.com.