The TriZetto Group Inc., the healthcare software management firm based out of Denver, Colo., has acquired Chandler, Ariz.-based Medical Data Express, a data encounter management software firm. The move is to exapand TriZetto’s managed Medicare and managed Medicaid software program. The software solutions, TriZetto claims serve more than 14 million Medicare Advantage and Part D members and over 12 million Medicaid members.
The software allows healthcare providers to meet federal and state mandates for claim submissions that require medical encounter data formats. The company says the use of encounter data supports the development of better quality measures for managing Medicare beneficiaries and building more accurate risk adjustment models.
This kind of encounter data includes diagnosis and treatment information for all medical or behavioral services obtained by a patient.
MDE supports Medicaid and Medicare plan customers that submit encounter data to more than 35 Medicaid state organizations and is positioned to meet the timelines established by CMS for Medicare Advantage plans. TriZetto says it will continue to make its Claims Data Manager application available to Medicare Advantage plans to process RAPs, or risk-adjustment processing, data submissions until the RAPs data requirement sunsets.