Claim Test Pro

  • bannerClaims testing has never been so organized.

    TriZetto can help your plan create an organized approach to testing claims data and help ensure the best possible test results are achieved. The TriZetto Claim Test Pro application enables your plan to test claims data efficiently and cost-effectively, and verify with confidence that correct claim totals are being paid. The solution greatly reduces the need for manual creation of test cases, automates the management and reconciliation of results, tracks and documents test projects and cases, and electronically converts system data to applicable testing data sets to create a robust and applicable testing environment.

    In addition, the Claim Test Pro application provides a comprehensive set of testing suites that provide for more diverse testing schemas, enabling testing of a multitude of provider reimbursement scenarios. The solution automates many processes that previously were done manually, helping plans increase administrative efficiencies by reducing the resources needed to manage these initiatives. An added benefit of the Claim Test Pro solution is that it provides management tools that track and report progress.

    Plans that do not have a strategy for testing and validating claims data may be at risk. Claim Test Pro can help you:

    • Reduce over payments to providers. Data that has been thoroughly vetted helps ensure that your plan is paying its contracted providers the correct amounts.
    • Reduce administrative costs. Reducing errors in provider payments reduces manual rework, helping drive down costs.
    • Reduce test cycle time. Automation can help you save hundreds of hours building and documenting test cases.
    • Reduce critical defects introduced to production. The application is virtually self-documenting, automatically summarizing what you have tested and reconciled.