TriZetto Provider Solutions™ Selected to Participate in CMS Limited ICD-10 End-to-End Testing

The Centers for Medicare and Medicaid (CMS) will conduct the first of three end-to-end ICD-10 testing weeks from January 26–30, 2015. This testing period will confirm that ICD-10 coded claims submitted by providers can be adjudicated by Medicare and that Medicare can send appropriate remittance responses back to the provider. TriZetto Provider Solutions was selected [...]

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On-Demand Webinar: Is Your Practice a Government Target

Catch the replay of the webinar, “Is Your Practice a Government Target” to explore a variety of audits and how they may impact your organization. The webinar featured industry leader and trainer in healthcare analytics and process improvement, Frank Cohen. Frank is the author of several books, including “Lean Six Sigma for the Medical Practice; [...]

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The Resurgence of RAC Audits

The RAC program began in 2009 with the goal of recouping Medicare payments considered to be “wasteful” or “fraudulent.” While the program has recouped more than $8 billion since its inception1, it puts a heavy financial burden on providers as it generates administrative costs for coordinating requests and legal fees for appealing results if providers [...]

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Top 10 List – Physician Risk Mitigation for Government Audits

By Carla Engle, MBA, product management expert, large physician groups and hospitals, TriZetto Provider Solutions  In February, the Centers for Medicare & Medicaid Services (“CMS”) announced that no additional Recovery Audit Contractor (“RAC”) reviews would be conducted with the current contractors, and the program has been on hold since June. However, CMS announced in August that [...]

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TriZetto Provider Solutions Announcement – Cognizant to acquire TriZetto

This morning, Cognizant has announced a definitive agreement to acquire TriZetto Corporation, including the TriZetto Provider Solutions business unit (formerly Gateway EDI, NHXS, and ClaimLogic). We believe this is a positive opportunity for both companies, and that it will provide numerous benefits to our clients. Click here to read the press release.

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