Agile Health Technologies’ QNXT Center of Excellence in blended-shore
model is enabling our customers to leverage full potential and benefit of
QNXT system, while reducing operational cost by 30% or more and
enhancing overall operational efficiency.
Agile QNXT CoE Overview
Agile Health Technologies Inc. is a healthcare information technology organization offering specialized business and technology solutions and services in product areas such as FACETS and QNXT for our Health Plan clients.
QNXT, one of the flagship products of Trizetto, is an excellent rule driven end to end Health Plan core administration solution. However, like any enterprise product, from implementation to operation and production support, it requires configurations, customizations, extensions and interfaces to meet the client specific business requirements. With constant changes in business rules, government mandates, technology etc.,there is a continuous need to upgrade and implement changes to the enterprise applications without impacting the core systems.
At Agile, our highly skilled QNXT experts are helping our clients to utilize the fullest potential of the QNXT system through seamless integration, configuration, extensions, upgrades and testing through our blended-shore QNXT Center of Excellence. Whether it is the QNXT enterprise, claims workflow, UM work flow or add-ons like Appeals and Grievances, Extended Integration (QXI), Financial modules (DOFR), our Center of Excellence is the best and most cost-effective alternative to OEM resources.
Through our blended-shore QNXT Center of Excellence, we offer:
• Product Implementation
• Application Integration (both with QXI and without QXI)
• Enhancements and Extensions
• Production Support
• Contact Center Agent Application Portal – Provide extensive view of Member (Eligibility, Claims, payments, invoices)
• Centralized Letter Generation System – to handle all print and fulfillment requirement (ID cards, EOB, provider communication) , FAX integration.
• Premium Reconciliation – Handle cost analysis of invoices and premium.
• Benefit Accumulator consolidation and tracking to provide better understanding of the services provided.
• Custom EDI Claims viewer for claims adjudicators.
• Custom workflows to handle manual claims adjudication processing.
• Tier and location-based PCP Auto Assignment with integrated ID Card Generation.
• Master Provider Repository based on NPPES Repository. Automated Data Stewardess updating provider data in QNXT based on NPPES repository.
Agile Health Technologies, with offices in Naperville, IL and Bangalore, India; provides the perfect mix of onshore – offsite team composition managed through our robust RMO and project delivery which is managed by the PMO process. This “follow the sun”
model of delivery brings in –
• Reduces implementation and operational cost for our clients
• Enables 24-hour support
• Faster delivery
• High quality due to both onshore and offsite quality inspections
• Ability to expand and contract staffing based on current needs
We are a HiTRUST accessed and HiTech Associates security certified and HIPAA compliant organization.
• Custom QConnect Processing Routines
• Custom Pre and Post Adjudication Routines
• Eligibility, Provider, Payments, Claims Extracts to Third Party Vendors
• Custom Edits and Pend for claims Adjudication
• Custom Reports Development and hosting in QNXT
• Custom Reports and Application Development and Integration with QNXT
Our Tools and Techniques
• Databases: SQL Server, Maria DB, MySQL
• Integration Tools: SSIS, BizTalk Server, Apache Kafka
• Reporting Tools : SSRS, Tableau, Power BI
• Operational Data Store, Reporting and Analytics
• Location Based Business Intelligence Services
• Hybrid and Cloud Based Application Development and Integration