Platform Integrates Medical and Pharmacy Data to Drive Real-Time Pharmacy Utilization Management Decisions
NEWPORT BEACH, Calif. and PHILADELPHIA, Jan. 12 /PRNewswire/ -- The TriZetto Group, Inc. and Sanovia Corporation today announced a definitive partnership agreement to offer the market's first platform that integrates real-time medical data with pharmacy data to automate prior-authorizations of medications and help plans manage pharmacy expenditures.
TriZetto's Facets(R) and QNXT(TM) core administration systems will integrate with PA-Logic(TM), Sanovia's automated pharmacy utilization management application, to confirm member eligibility, benefit design and formulary status and apply best-practice clinical guidelines to evaluate provider requests for select medications. The integrated data platform enables Integrated Healthcare Management and will be available to TriZetto customers in mid-2009.
"In combining the access of real-time medical claims data with Sanovia's pharmacy utilization management application, this integrated system will use built-in intelligence to drive automation, standardization and consistency in the evaluation of pharmaceuticals," said Marty Mattei, Pharm.D., TriZetto's director of pharmacy solutions. "The result will be a more efficient workflow process that helps reduce administrative costs associated with managing the pharmacy benefit. Additionally, because the Integrated Healthcare Management platform enables more efficient collaboration between the payer, provider and member, it will enhance quality of care and help reduce clinical costs by optimizing therapeutic regimens, thereby helping ensure the appropriate use of pharmaceuticals."
"Health plans seek a better way to manage the utilization of expensive specialty pharmaceuticals," said Jerry Osband, M.D., TriZetto's chief medical officer. "Pharmacy staff at payer organizations today must access data from two disparate systems - the core administration application and the pharmacy benefit software - relying on a somewhat manual, paper-intensive process to route and review information and communicate with both patient and physician. This new, integrated platform from TriZetto and Sanovia will automate the process and improve consistency."
"We are very pleased to join together with TriZetto to provide the only solution in the market that will link an automated, paperless pharmaceutical prior-authorization system with a health plan's core medical claims system, offering real-time access to all of the information needed to make timely, accurate and consistently appropriate clinical decisions backed by best-practice clinical guidelines," said Robert Tremain, Sanovia's president and chief executive officer.
TriZetto's Facets and QNXT applications help health plans meet their business requirements across claims processing, claims re-pricing, capitation/risk fund accounting, premium billing, provider network management, group/membership administration, referral management, hospital and medical pre-authorization, case management, customer service and electronic data interchange. Available on a hosted or non-hosted basis, the two systems can be combined with TriZetto and third-party software to address the enterprise-wide needs of managed care organizations.
Sanovia's PA-Logic uses best-practice clinical guidelines to evaluate pharmaceutical requests, help ensure adherence to benefit designs and enable appropriate decisions when requests are made. The system manages and automates the pharmacy review process on an electronic platform, which reduces slow and error-prone paper-based methods, speeds routing of information and accelerates decisions to help prevent treatment delays. Plans can also allow their participating providers to access the system from their offices via the Internet, and submit requests electronically, thus eliminating the frustration of dealing with paper forms, phone calls and returns for incomplete information. PA-Logic's letter writer and report generator functions automate workflow, produce real-time reports on pharmacy program operations and facilitate communications with patients and physicians.
About Sanovia Corporation
Sanovia integrates smart business practices with automated decision-making technology and best-practice clinical guidelines, delivering proven savings in administrative costs and pharmaceutical spending for managed care companies and their customers. Sanovia's portfolio of innovative products and services meet the increasing challenges of pharmaceutical administration, validation, documentation, utilization, cost and workflow management. Clients use Sanovia's "intelligent" clinical decision support products to balance pharmaceutical cost management with appropriateness of therapy and quality of care. Sanovia is privately held and venture-backed, with no ownership by any pharmacy benefit manager, health plan or pharmaceutical manufacturer. Headquartered in Philadelphia, Sanovia can be reached at 610-521-2211 or at Sanovia.com.
Founded in 1997, TriZetto is the fastest-growing, privately held healthcare information technology company in the U.S. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare Management(TM). TriZetto provides information technology solutions that enable health insurance payers and other constituents in the healthcare supply chain to improve the coordination of benefits and care for healthcare consumers. The company's offerings include enterprise and component software, hosting and business process outsourcing services, and consulting.
|SOURCE Sanovia Corporation|
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