North Carolina, Kansas City Blue Plans Collaborate to Provide Administrative Services

CHAPEL HILL, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) and Blue Cross and Blue Shield of Kansas City (BCBSKC) announced today that they will collaborate in an initiative that will position the companies to meet the new market demands required by a fast-changing health insurance landscape.

 

This joint effort will be undertaken by Topaz Shared Services, LLC (Topaz); BCBSNC and BCBSKC will be its initial members.  Topaz will provide services such as claims processing, enrollment and billing for the individual and small-group markets.

 

The TriZetto Group, Inc., one of the nation’s leading providers of IT solutions for health care organizations, will provide a business solution set that includes enterprise-wide software, application management and consulting services to support Topaz. The TriZetto solution set will help streamline insurance plan design and enable benefits administration, care and network management  and member/provider engagement.

 

“Topaz is evidence of how serious we are about continuing to compete and win in North Carolina’s rapidly evolving health insurance marketplace,” said BCBSNC President and CEO Brad Wilson.  “Topaz will accelerate our transformation as a company, bring new capabilities to our customers and fuel our efforts to be a more efficient company.”

 

Topaz has three primary objectives: increased speed of new products to market, greater innovation and improved cost efficiencies.  BCBSNC and BCBSKC believe that the solutions offered by Topaz will be attractive to other Blue plans in the future.

 

“Creating Topaz will allow us to accelerate the technology, business and product changes we need to make to remain competitive in a consumer-oriented marketplace,” said BCBSKC President and CEO David Gentile. “This transition demonstrates the transformation our company is undertaking currently, to ensure we remain a market leader in Kansas City.”

 

As health insurance exchanges created by the health care reform act open in 2014,  Topaz will utilize TriZetto’s retail capabilities to provide services for BCBSNC and BCBSKC’s individual and small group customers. 

 

“With reform bringing millions of additional people into the system, our end-to-end solutions will help Blue plans and all TriZetto clients transform their operations to compete and win in a more retail-based, consumer-oriented health care landscape,” said Trace Devanny, Chairman and Chief Executive Officer of TriZetto.  “Our partnership with Topaz highlights our commitment to develop innovative approaches to help our clients succeed in the new world of health care reform.”

 

BCBSNC and BCBSKC are now recruiting employees from within their organizations to fill key roles in the transition of work to Topaz. As Topaz becomes operational over the next several years, BCBSNC and BCBSKC anticipate that the number of employees working on the Topaz initiative will increase accordingly.

 

 

Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 77 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at bcbsnc.com.

Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue Cross and Blue Shield of Kansas City provides health coverage services to nearly one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on the company, visit its Web site at BlueKC.com. Our mission: to use our role as the area's leading health insurer to provide affordable access to health care and to improve the health and wellness of our members.

 

About TriZetto:

TriZetto provides world-class health care IT software and service solutions that drive administrative efficiency, improve the cost and quality of care, and increase payer and provider collaboration and connectivity. TriZetto solutions, many of which are patented or patent-pending, touch half the U.S. insured population and reach more than 21,000 physician practices. TriZetto’s payer offerings include enterprise and component software, application management services, business management services and consulting services. Provider offerings, delivered through TriZetto’s Gateway EDI wholly owned subsidiary, include tools and services that monitor, catch and fix claims issues before they can impact a practice. TriZetto’s integrated payer-provider platform will enable deployment of promising new models of post-reform health care. For information, visit trizetto.com.

 

Topaz Shared Services, LLC, is a Delaware limited liability company; Blue Cross and Blue Shield of North Carolina and Blue Cross and Blue Shield of Kansas City are its charter members.  Topaz will provide key business systems and processes for health insurance plans, including functions related to medical claims processing, member enrollment and billing services.

 

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