GREENWOOD VILLAGE, Colo. - August 12, 2010 - Like health plans throughout the country, El Paso First Health Plans, Inc. faced looming ANSI x12 5010 and ICD-10 compliance deadlines. But El Paso faced additional hurdles – submitting a compliance plan to the State of Texas that proved their 5010 readiness, while moving their organization to a new facility. And they needed to get it all done in about a month.

“Of course we were aware that 5010 and ICD-10 deadlines were coming up,” said Sharon Perkins, director of information technology at El Paso. “But, when we found out we had to submit a 5010 compliance plan to the state at the same time we would be relocating to a new facility, we wanted some help. We turned to The TriZetto Group because they are a leading service and technology provider in the payer space and their Advantage 10 Compliance Plus Service is an all-encompassing solution to create a roadmap for compliance.”

The TriZetto Advantage 10 Compliance Plus service is a multi-phase solution that helps payers assess their readiness for 5010 and ICD-10 compliance, build a project plan, and migrate to 5010 and ICD-10 codes. The service identifies the impact to a payer’s business and technical operations; determines how the business operations will leverage the richness of new data; defines detailed project plans including data conversion, testing and cut-over strategies; and integrates the new transactions and code sets into their core administration systems. Although the service covers all aspects of compliance readiness, it is flexible enough to assist health plans wherever they may be on their compliance preparation path, with a modular approach that allows payers to pick and choose the services they need.

“Understanding our very short turnaround time, TriZetto’s Advantage Services team divided into three groups,” Perkins continued. “TriZetto sent the right people who asked rapid, on-target, relevant questions. The experience and background of each person brought an expertise that allowed us to move quickly. We would not have met our short timeframe without TriZetto’s skilled and knowledgeable team.”

Within a three-week timeframe, TriZetto interviewed El Paso’s team, evaluated its compliance gaps and created a roadmap for 5010 and ICD-10 that included suggestions about how to leverage ICD-10 across its provider contracts and business workflows and improve operations. El Paso used this assessment for the final plan that was submitted to the State of Texas, which approved the plan with no edits or exceptions. In addition, El Paso took the roadmap they created with TriZetto and turned it into the official operating plan that will drive the entire organization’s change to 5010 and ICD-10.

“It was extremely valuable for us to bring in an expert early on to help us prepare for compliance,” said Perkins. “In fact, I can’t stress that enough. By engaging TriZetto early in our planning process, we were able to see the specific areas of the business that needed attention—areas we hadn’t thought would be affected at all—and begin taking action immediately. We are moving forward now with our eyes wide open, and the process has been incredibly beneficial to our organization.”

“El Paso’s fast-track timeline highlights how TriZetto’s compliance readiness services can adapt to fit the needs of any health plan, whether they are just beginning their 5010 and ICD-10 compliance project or are ready to start making changes to their business and technology infrastructure,” said Greg Larson, associate vice president of services product management for TriZetto. “Our modular service allows us to identify quickly gaps in a payer’s 5010 and ICD-10 plans, develop a roadmap to fill the gaps and meet the organization’s long-term goals of leveraging the amazing capabilities made possible especially by ICD-10, and even complete the migration for the health plan if needed.”

El Paso First Health Plan’s Sharon Perkins and TriZetto’s Greg Larson are available for interviews by contacting Schwartz Communications at Trizetto@schwartzcomm.com or 781-684-0770.

About El Paso First Health Plans, Inc.

Established in 1999, El Paso First Health Plans was created for the sole purpose of providing affordable healthcare for the community. As a local, not-for-profit organization, El Paso First is uniquely suited to achieve its goal and mission of serving its member and provider community. El Paso First offers a wide variety of products and services, each designed to target specific needs in the community. El Paso First participates in Texas Medicaid, Texas Children’s Health Insurance Program (CHIP), Third Party Administration, and manages an Indigent Care program for our local county hospital district.

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry, with its technology touching half of the U.S. insured population. TriZetto’s vision for the industry, Integrated Healthcare Management, is the optimized coordination of benefits and care for healthcare consumers to improve the value of every healthcare dollar spent. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

Media Contacts:

The TriZetto Group
Rachel Tanner Lew
303-495-7022
rachel.lew@trizetto.com

Davida Dinerman or Pauline Louie
Schwartz Communications
781-684-0770
trizetto@schwartz-pr.com