TriZetto, Sanovia Join Forces to Offer First Integrated Platform That Helps Payers...

* Reuters is not responsible for the content in this press release.

Mon Jan 12, 2009 7:01am EST

TriZetto, Sanovia Join Forces to Offer First Integrated Platform That Helps
Payers Control Pharmacy Costs

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.

About TriZetto 
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

Brad Samson, TriZetto, +1-949-719-2220, brad.samson@trizetto.com, or Melissa
Bruno, Schwartz Communications, +1-781-684-0770, trizetto@schwartz-pr.com, for
TriZetto; Kerry Peters, Sanovia, +1-610-521-2211 ext. 509,
kpeters@sanovia.com
Comments (0)
This discussion is now closed. We welcome comments on our articles for a limited period after their publication.