TriZetto Corporation today announced the general availability of its
EDGE Server solution for healthcare payer organizations.
In 2012, CMS introduced the External Data Gathering Environment (EDGE)
server concept as the standard distributed data collection method.
TriZetto’s technology and services solution enables health plans to
securely capture and provide enrollment, medical claims and pharmacy
claims data to the U.S. Department of Health and Human Services (HHS).
This data is required of all healthcare payers participating in state
and federal health Exchanges, as well as individual and small-group
TriZetto’s Encounter Data Manager for EDGE Server application is
pre-mapped to the company’s FacetsTM and QNXTTM
core administration systems. These systems are used by more than 50
health plans in Exchanges and more than 60 payers in the individual and
small-group markets. The Encounter Data Manager for EDGE Server
application also integrates with non-TriZetto administrative systems
that must comply with the encounter data requirements.
“For more than a decade, TriZetto has helped managed Medicare and
Medicaid plans submit encounter data to federal and state agencies,”
said Diana Benli, TriZetto’s vice president of product management,
government payer solutions. “We securely manage such data for plans
covering nearly 30 percent Medicare and 50 percent Medicaid recipients.
TriZetto brings the requisite experience and know-how.”
HHS, through the Centers for Medicare & Medicaid, recently updated EDGE
server requirements for health plans. By the end of the summer, payers
must choose to use a cloud server through Amazon Web ServicesTM
or an on-premise server. TriZetto’s solution supports both choices,
consolidating, scrubbing, masking and feeding encounter data to either
server option. This flexibility will enable health plans to move swiftly
to meet the looming deadline.
“These updated requirements and new ones down the road require an
experienced, steady hand, and that’s where our services team comes in,”
said Dan Skari, solution general manager, healthcare reform, at
TriZetto. “In addition to the encounter data application, TriZetto’s
EDGE Server solution includes consulting, business management and
application management services. Informed by years of experience in
encounter data management, our team will help healthcare payers speed
implementations, oftentimes in as little as 10 to 12 weeks1
and respond nimbly to changing, evolving regulations and compliance
TriZetto’s Encounter Data Manager for EDGE Server application currently
used by health plans in 36 states for Medicaid and Medicare, includes
data scrubs; flexible data maps; formats that support compliance for
populating medical encounter, pharmacy claims and enrollment data in
servers; and both licensed and hosted delivery models.
About TriZetto Corporation
TriZetto Corporation provides world-class information technology and
service solutions that help payers and providers work more efficiently
to deliver better health. TriZetto solutions touch over half the U.S.
insured population and reach more than 230,000 care providers. TriZetto
helps healthcare organizations enhance
administrative efficiency; improve
the cost, quality and delivery of care; address compliance; and
compete to win in an emerging retail market. Payer solutions include benefits
management and portal platforms, as well as consulting,
management and business
management services. Provider solutions include real-time
eligibility assurance, claims editing, revenue
cycle management technology and services that help providers get
paid quickly and accurately. For more information, visit www.trizetto.com.
1 Individual client implementation time may vary.
Wesley Bryant-King, 303-542-2571
Source: TriZetto Corporation