In a move meant to help payers simplify the management of complex reimbursement rules, McKesson and Cognizant subsidiary TriZetto are partnering to integrate McKesson's ClaimsXten and ClaimsXten Select clinically-based claims auditing tools with TriZetto's QNXT enterprise core claim administration technology.

Regulatory and competitive pressures are forcing payers to work toward improved efficiencies and better customer experience. By combining the two platforms, McKesson and TriZetto will be able to help health plans automate payment and medical policy, simplify management of complex clinical and reimbursement rules, the companies said. 

[Also: ICD-10: Providers can recoup millions of dollars in lost revenue by analyzing claims denials, data scientist says]

"This new integration will help health plans boost auto-adjudication rates, minimize manual effort and take advantage of industry-leading clinically sourced content to provide timely and consistent reimbursement of claims," said Alan Stein, senior vice president, payer product management for TriZetto.

Officials note that "stringent certification process" derived from the McKesson and Trizetto's previous integrations will help ensure the reliability of the interfaces between ClaimsXten and QNXT systems.

"Building on our past success developing interfaces between McKesson ClaimsXten and and TriZetto Facets, this integration with QNXT will help ensure smooth transitions – especially from McKesson ClaimCheck to ClaimsXten Select – and a viable growth path for health plans challenged with scaling mixed fee-for-service and value-based models to operational levels," said Carolyn Wukitch, senior vice president of McKesson Health Solutions.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

Like Healthcare IT News on Facebook and LinkedIn