BCBST of Tennessee Chooses TriZetto’s NetworXPricer for Claims Processing

The TriZetto Group Inc. announced that BlueCross BlueShield of Tennessee (BCBST) has purchased NetworXPricer, software that fully automates complex provider contracts, reportedly making it easier for health plans to negotiate terms with numerous providers.

NetworXPricer reportedly speeds claims processing by eliminating the labor costs, errors and inconsistencies of pricing claims manually. BCBST, the state’s largest health insurer, made the decision as part of its ongoing strategy to automate and streamline operations.

“Using the natural language feature of NetworXPricer, we can dramatically reduce the time it takes to set up and maintain contract terms in our system,” said Bob Worthington, senior vice president of business operations for BCBST. “TriZetto’s technology will boost our efficiency and help us with our twin goals of providing affordable coverage for all Tennesseans and assuring the company’s long-term sustainability.”

NetworXPricer, adapted from TriZetto’s NetworX suite of products serving the PPO marketplace, is a standalone product that can be used with any health plan’s administrative system. It is also integrated with Facets, TriZetto’s flagship administrative software.

“Health plans like BCBST that combine NetworXPricer with Facets are using TriZetto’s sophisticated technology to its fullest advantage,” said Tony Bellomo, president of TriZetto’s software unit. “Our NetworX system can help health plans reduce errors and tighten claims processing, even as provider contracts become more complex.”

BlueCross BlueShield of Tennessee is the state’s oldest and largest not-for-profit health coverage provider, serving more than 2 million Tennesseans.