White Paper Details Five Ways Payers can Improve the Provider Contract Renewal Process

NEWPORT BEACH, Calif. - Dec. 11, 2008 - You work for a health plan, and you're responsible for provider contracting and ensuring that contracts are renewed on time. What happens when a provider wants to negotiate different terms? How many resources do you have to rally to evaluate the proposed rates and terms? Do you have tools and resources to respond quickly? You certainly don't want to risk the chance of a contract terminating or the added effort of reprocessing claims because an agreement couldn't be reached by a pre-determined date.

"The harsh reality for many payers is that preparation for provider contract renewals consists of using homegrown and disconnected information systems to model only a select few of the most important contracts," said Dave Pinkert, senior vice president of product management at TriZetto. "It's a time-consuming process that involves multiple resources across the organization, minimizes the ability to uncover opportunities for greater gains and seriously affects the payer's ability to negotiate win-win pricing structures."

Expert advice on five ways to improve the provider contract renewal process is presented in a white paper, "Maximizing Network Operations," released today by The TriZetto Group, Inc. TriZetto provides software and IT services that help payers drive integrated healthcare management: the convergence of benefits administration, care management and constituent engagement to improve U.S. healthcare.

The specific advice shared in TriZetto's white paper includes:

1. Compress the contract renewal process timeline,
2. Configure contract terms to net the best unit cost,
3. Create transparency and minimize risk,
4. Successfully negotiate with informed providers and
5. "Stack the deck" by prioritizing contract renewals for the biggest gains.

"While this advice is sound, its execution proves problematic for many payers," noted Pinkert.

Pinkert said TriZetto's white paper details information technology and processes that payers can employ to carry out the five suggestions and effectively manage the entire network management process from contract renewal to claims pricing.

TriZetto's new network operations white paper is available by request at salesinfo@trizetto.com. Requests by news media for the white paper or for interviews with Pinkert may be directed to Schwartz Communications at 781-684-0770 or trizetto@schwartz-pr.com.

About TriZetto

TriZetto is Powering Integrated Healthcare Management™. With its technology touching more than half of the U.S. insured population, TriZetto is uniquely positioned to drive the convergence of health benefit administration, care management and constituent engagement. The company provides premier information technology solutions that enable payers and other constituents in the healthcare supply chain to improve the coordination of benefits and care for healthcare consumers. Healthcare payers include national and regional health insurance plans, and benefits administrators that provide transaction services to self-insured employer groups. The company’s payer-focused information technology offerings include enterprise and component software, hosting and business process outsourcing services, and consulting. Headquartered in Newport Beach, Calif., TriZetto can be reached at 949-719-2200 or at www.trizetto.com.

CONTACTS:

Government Relations Contact::
The TriZetto Group, Inc.
Brad Samson
949-719-2220
brad.samson@trizetto.com

Media Contact:
Schwartz Communications
Melissa Bruno
781-684-0770
trizetto@schwartz-pr.com