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The TriZetto® PPO module for provider network management integrates with the QicLinkTM Extended Enterprise system to enable users to efficiently re-price negotiated benefits to contracted providers, and offers all the administrative functions you need to process PPO benefits and reports and track discount information.
By applying this module in conjunction with your QicLink e2 system, you can establish point-of-service plans, as well as unique contracting arrangements on a provider by provider, or provider to many master, basis; as well as set up a variety of flexible options for providers and their rates. The module provides:
Benefits:
- Recognition of contracted and non-contracted providers
- Automatic application of appropriate rates with no adjuster intervention
- Accommodation of different contract structures:
- Fee schedules
- Discount percentages
- Per diems
- Relative value scale (RVS) factors
- RBRVS
- Negotiated rates
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Information
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For more detailed information, please call 1-800-569-1222 or click on the link below.
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Online Support:
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