Xpress Encounter Pro

Complete Encounter Management Software

Encounter Processing (extraction, delivery, tracking, editing and resubmission) is often a process that is given limited focus in many Medicaid & Medicare health plans until the plan is warned or even sanctioned by the managing state agency. TriZetto has a complete encounter processing system that works for one or many states. Xpress Encounter Pro offers health plans a solution that works for both Medicaid and Medicare encounters for all claim types. The software is modular, allowing our potential clients to pick and choose only those functions that they need. TriZetto has already mapped Xpress Encounter Pro to most major claims payment systems.

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Usability & Functionality

User selectable criteria for extract include (but are not limited to):
Claim Type | DOS | Plan | Provider | Specific Claims
Tracking of claim submission indicators and historical extractions
Automated delivery and tracking of file submissions
Executive summary reports per encounter cycle
Detailed error/pend reports for swift handling of encounter problems

Technical

Xpress Encounter Pro is written using modern, highly supported .Net technology from Microsoft. Although the database engine is Microsoft SQL 2005, our products support virtually any modern database technology available today. Below is a summary of supported software and technologies.

Major claims systems already mapped: AMISYS, Diamond, FACETS, HealthTrio, QMACS, QNXT, OAO and others
Database Support: MS SQL 2000/2005, Oracle, DB2, ACCESS, AS400 ODBC and more...

Benefits

Manage all encounter files and data for one or multiple states in one application/database
Complete end-user tools for editing, correcting and deleting encounters
Integrates directly with claims payment system to automate replacements and voids
Improve health plan accuracy and timeliness scores
Fast and Accurate implementation, most completed between 45 - 60 days