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Great Lakes Health Plan (GLHP) is the second-largest Medicaid managed health plan in Michigan, serving more than 155,000 members. GLHP needed a solution that would automate the pricing of OPPS claims and meet state compliance standards, support efforts to strengthen provider relations, implement rapidly and without interrupting provider reimbursements, integrate with the Facets core administration system on which claims are processed, and with the Ingenix HSS system, which GLHP planned to use for additional processing of OPPS claims. After discussions with both GLHP management and Americhoice management, Wentzel received approval in September 2006 to license the NetworX Pricer application from TriZetto.

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Format:PDF
Date:Mar 2008

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