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Clear Choice Moves BPO Services For Claims To TriZetto

Mr. Gibford anticipates this agreement to deliver savings in operating expenses

Clear Choice Health Plans and its business process outsourcing (BPO) vendor, Adaptis, have mutually agreed to terminate their business relationship. In conjunction, Clear Choice has entered into a five-year contract for BPO services with TriZetto Group, an information technology and services company focused on the health care industry.

The agreement calls for TriZetto to provide claims administration, enrollment administration, billing, mailroom and business rules configuration (BRC) services. TriZetto will manage and host the underlying QNXTTM enterprise administration system and related software from its data centers, said the company.

Patricia Gibford, president and CEO of Clear Choice Health Plans, said: “This agreement will enable Clear Choice Health Plans to achieve improved customer service levels through increased accuracy, efficiencies, reduced overhead costs, and improved functions such as claims payment, enrollment, and insurance premium billing. Since our previous outsourced services were delivered on TriZetto’s enterprise administration platform, we anticipate being able to move our existing data and claims history over to TriZetto’s business process services center without customer disruption. This new agreement should deliver savings in operating expenses in both the short and long term.”

The transition is expected to be completed in the fourth quarter of 2009.