'FACETS Center of Excellence'

Agile Health Technologies’ FACETS Center of Excellence in blended-shore model is enabling our customers to leverage full potential and benefit of FACETS system, while reducing operational cost by 30% or more and enhancing overall operational efficiency.

Agile FACETS CoE Overview

Agile Health Technologies Inc. is a healthcare information technology company offering specialized business and technology solutions and services in product areas such as FACETS and QNXT for our Health Plan clients.

FACETS, one of the flagship products of Trizetto, is an excellent 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, technological advances etc., there is a constant need to upgrade and changes to the enterprise application without impacting the core systems.

FACETS Healthcare – At Agile, our highly skilled FACETS experts are helping our clients in utilizing the fullest potential of the FACETS system through seamless integration, configuration, extensions, upgrades and testing through our blended-shore FACETS Center of Excellence. Whether it is Plan / Product configuration, Provider Networks or Fee Schedule, NetworX Pricing, ExternalClaims and Accumulator updates, Workflow management integrating external applications like Claims Xtend; our Center of Excellence is the best and most cost-effective alternative to OEM resources. We are your partner in your healthcare business operation using FACETS.

  • Our Offerings
  • FACETS Implementation and Upgrades
  • Configuration, process, and workflow management
  • Application Integration and external interfaces
  • Real-time integration and FXI services
  • Enhancements and Extensions
  • Testing Services
  • Production support and batch operation
  • Our Credentials
  • Developed the integration and SOA components for a large health plan using FACETS.
  • Implemented the complete FACETS batch processing and error handling process using Tidal for a health plan on the west coast.
  • Implemented the complete FEP program in FACETS
  • Implemented Prime PBM with real-time accumulator update to and from FACETS.
  • Complete plan/product benefit testing for a large health plan
  • Automated the Fee Schedule load process for a large health plan
  • Implemented letter server for a health plan on the west coast
  • Automated the billing receipt and premium reconciliation process
  • Developed customized small and large group rating system and automated rate upload to FACETS
  • Our Blended-Shore Model
FACETS Healthcare Technology, located 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 costs 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 Hi-TRUST accessed and Hi-Tech Associates security certified and HIPAA compliant organization.
  • Outsourcing Services
The agile healthcare technology company, our Center of Excellence is providing best in class Outsourcing services in the following areas –
  • Provider and Network  Management  – We at Agile help our Clients manage their annual Provider and network assignment along with the agreements.  We help set up the agreements and conduct user acceptance testing on their behalf.
  • Configuration and Benefits Management – Every year Health Plans roll out new products and changes. We help our Clients in configuration and benefits validation using our proprietary benefit testing Tool BenefitPro or Client specific tools.
  • Pricing and Agreements – We specialize in Managing provider pricing and Network configuration. We configure agreements and pricing and validate the pricing using custom reports and Claim Processing.
  • Enrolment and Billing – Our Services include Validation of new enrolment processes and systems, annual rate validation, and specimen billing validation.  Billing reconciliation and Broker Commission processing.
  • Claims Analytics and Recovery – We assist Clients in their analytics by providing ad hoc reporting and data presentation. We also help in their overpayment recovery process and corrections.  We also perform validation for Configuration changes, Productions Incidents and new changes.
Our Outsourcing model employs a flexible resource plan, duration, and schedule based on clients' needs. Our model offers a unique blend of Knowledge and flexibility which can assist Clients in their operation and increase savings.
  • Our Niche
  • Product Benefit configuration and testing
  • NetworX Pricing configuration and FEE Schedule loading
  • Automated Enrollment
  • Claims and EXCD configuration and testing
  • ITS Claims Processing
  • Utilization Management
  • Formatted outputs, ID cards, Letters, and Invoice generation
  • External claims and accumulator updates
  • Accumulator Synchronization Process
  • Billing Receipt automation
  • Group rating systems automation and rate upload
  • PBM Integration both real-time and batch
  • Integrating external applications such as Claims Xtend, ClearCoverage, Care Advance, etc.
  • Medicare Management / EAM implementation
  • FACETS Consumer-Directed Health (CDH)
  • EDI processing – 834, 835, 837, 820, 270/271, 276/277 transactions
  • HIPAA Gateway implementation

Nest Step

For more details, email us at sales@agilehealthtech.com.

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