About TriHealix What We Do Multiple platforms, technologies, and intermediaries – reduced to one. TriHealix has created an integrated healthcare and financial transaction platform designed to administer today's more complex health insurance products and streamline the settlement process between payors and providers. It creates new cost and administrative savings and valuable new functionality at nearly every transaction stage of the health insurance process - from pharmacy and physician point of sale, to back office adjudication and payment at health insurers and benefit administrators. It means new convenience and simplicity for consumers. And it comes at a critical time for the healthcare system with the multiplying payment and administrative responsibilities in the new "consumer driven" environment. How We Do It Bridging the Gaps The vision of TriHealix is to bridge the gaps that exist today throughout the healthcare payment process, creating access and visibility for all parties to a healthcare transaction, including providers, payors, and consumers. From the initiation of a transaction, to authorization, to the receipt of payment and reconciliation, TriHealix has built the infrastructure that interconnects data and procedures previously trapped in silos to create one, streamlined and simplified experience. This allows for both real-time and batch settlement leveraging hold and settle capabilities. Transactional Transformation The TriHealix Platform enables the simultaneous, electronic communication and data sharing by all parties to the healthcare transaction - from the point of care, to the consumer's insurance company(s), to their financial institutions, and back. From a single claim submission, TriHealix processes the claim and returns a single, aggregated authorization response combining payment from both payor and multiple sources of consumer funds. This claim transformation reduces administrative costs and transaction fees, streamlines payment, dramatically reduces provider collection efforts, and creates a better end to end experience for providers and consumers. Getting Connected To initiate this transactional transformation and reduce operating expenses, TriHealix Provider Solutions offers easy to use tools and point of sale systems to connect healthcare providers to its platform. TriHealix offers competitive pricing for credit/debit card acceptance and the ability to participate in our payment assurance program - an innovative program providing access to multiple sources of consumer funds. Providers connecting to our platform will benefit from consolidated payment from both payor and consumer, and receive an integrated statement that details the sources of funds for all transactions for quick and easy reconciliation. Using TriHealix technology, we combine payment functionality with the information on health plan membership cards to provide consumers access to the TriHealix platform with all of its advantages. Consumers with a TriHealix enabled card can ensure that all available sources of funds (health benefits and financial accounts) are tied to their card. By issuing a TriHealix integrated card, payors improve the consumer's experience at the point of care, helping them to maximize reimbursement and reduce out of pocket expenses. Consumers benefit by receiving a single, understandable statement of activity for all healthcare related transactions. Why Us: The TriHealix Story Consumerism – The Unsolved Problem Back in 2001, the founders of TriHealix led the management team at HealthMarket - a pioneer in the consumer driven health plan revolution. "Consumerism" visionaries believed that if more responsibility were shifted to the consumer like in any other industry - costs could be contained. To make it work, consumers and providers needed accurate, real-time information that was easy to use and understand at the point of care. To adjudicate claims, payors needed to communicate directly with the parties as well. HealthMarket succeeded in solving the front-end of the equation: consumers could view cost and services data they never had access to. But a major problem remained: There was no back-end system in existence capable of handling the complexity or requirements of the constantly evolving, new consumer driven plan designs. The founders realized: The healthcare transaction system wasn't built to deliver real-time answers at the point of care, so providers and consumers couldn't get the vital information necessary to understand benefits and their financial responsibility. Real time information couldn't flow to all parties because the system couldn't get the claim information into an electronic format (EDI). The financial rails in place weren't robust enough to capture the level of data needed for healthcare benefit adjudication. Nor could they capture financial account information from multiple sources like personal accounts and the new healthcare spending accounts that the plans demanded. The transaction "pipes" themselves could not connect directly between payor and provider as needed. Numerous intermediaries and disparate operating systems posed a challenge to create the end to end connectivity needed. The Industry Is Challenged The TriHealix founders realized that without a new platform capable of capturing data and integrating communications, the system would simply get farther and farther behind as consumerism advanced. The scenario would look like this: The rapidly multiplying number of accounts would provide confusion and added complexity for providers and consumers alike. This would increase the burden on an already strained claims processing system, making processing more costly. As waste and duplication become rampant, and providers faced higher fees, more bad debt and reduced cash flows, they would look toward payors for relief or begin charging consumers at the point of care. Enter TriHealix In the Spring of 2006, TriHealix's founders accepted the challenge and began development of a technologically advanced and integrated platform capable of processing both healthcare and financial transactions and providing end to end connectivity between payors, providers and consumers. © 2008 TriHealix, Inc. All Rights Reserved. | Terms of Use | Privacy Policy