NEWPORT BEACH, Calif. - March 3, 2010 - The TriZetto Group, Inc. today announced the general availability of the QNXT™ 4.7 system release, another product in its enterprise administration suite to support ANSI x12 version 5010 transaction and ICD-10 code requirements. This newest version of the healthcare IT company's QNXT application includes more than 25 new enhancements to help payers comply with ICD-10 code sets while offering new capabilities such as enabling value-based benefit designs. In addition, the TriZetto Advantage 10 Compliance Plus™ upgrade service gives payers the ability to take advantage of ICD-10 data for strategic initiatives. QNXT is currently used by 48 payers processing benefits for 14 million members.

"TriZetto's QNXT 4.7 release gives our customers and payers needing to upgrade their core administration system an easy and rapid path to install, test and move into production with a system that allows them to be 5010 and ICD-10-compliant," says Marty Newton, associate vice president of product management at TriZetto. "This new version of our proven QNXT platform will allow customers to meet their deadlines and also increase performance, improve efficiency, and support new benefit designs through value-based benefits that reward consumers for healthy lifestyles and behaviors."

The latest version of the QNXT application, coupled with TriZetto's Advantage 10 Compliance Plus upgrade service, enables payers to meet federal requirements and better use ICD-10 codes to develop more complex wellness programs and benefit designs. By taking advantage of the numerous enhancements to Version 4.7, the TriZetto Advantage 10 Compliance Plus service team can work with payers to develop an ICD-10 migration roadmap and other planning tools. With this planning, the QNXT upgrade can help payers drive new care management programs, define more profitable provider contracts and increase the information shared between members, providers and payers.

"While the QNXT 4.7 application will give payers the tools they need to become more competitive, the upgrade services will show them how to best use those tools and maximize the value of new, more granular data they receive," said Mike Jenner, executive vice president of TriZetto services. "The TriZetto Advantage 10 Compliance Plus upgrade service uses a team of certified employees to help QNXT customers get ahead of the compliance curve and build more effective programs including rewards and incentives, wellness, and disease management. By bringing together software and services, we can help ease our customer's migration pain while developing a plan to enhance functionality."

The QNXT 4.7 upgrade also will integrate with TriZetto's Value-Based Benefit Solution, available separately in 2010. The solution, announced in November 2009, will automate the tasks of tailoring benefits and claims adjudication to the specific clinical conditions of high-risk members and rewarding participation in health, wellness and condition-management programs. The application will trigger value-based claims adjudication within the QNXT 4.7 system and power Web applications that can be used by payers to administer comprehensive value-based benefits programs or by members to view incentive benefit options and activity.

In addition, the QNXT upgrade provides the ability to support both ICD-9 and ICD-10 codes at the same time, giving health plans the flexibility to migrate to ICD-10 when completely configured. The additional flexibility also gives plans the ability to vary payment amounts to providers, when permissible. Further, QNXT 4.7 includes an "upgrade framework" that will allow customers to upgrade to this and all future QNXT upgrades faster and more efficiently.

About ANSI x12 Version 5010 Transactions and ICD-10 Code Sets

A prerequisite for ICD-10, 5010 transactions define the rules for electronic data transmission of healthcare data such as claims, while the ICD-10 code set provides a much more extensive way to track diagnoses and procedures than its ICD-9 predecessor. Payers must demonstrate their ability to receive HIPAA 5010 transactions in a test environment by January 2011, to move those 5010 transactions into production by January 2012, and to be able to accept ICD-10 codes by October, 2013. For more information, please call 1-800-569-1222 or visit www.trizetto.com/ICD-10.

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare Management®, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.

Media Contacts:

Rachel Tanner Lew
The TriZetto Group
303-495-7022
rachel.lew@trizetto.com

Melissa Bruno
Schwartz Communications
781-684-0770
trizetto@schwartz-pr.com