Hiring a Subject Matter Expert in Facets™ is necessary when implementing, upgrading, installing required patches and or testing. It’s not only a full-time job, it takes knowledge and experience to understand how Facets™ operates. In the healthcare industry, the rise of new challenges such as changing consumer demand, government regulations and shifts in medical cost are some of the reasons why an insurance company should seek the assistance of subject matter experts (SMEs).
When you combine the knowledge of HIPAA 5010 & ICD-10 as well as being skilled in Facets™, it is a recipe for success. Subject Matter Experts are crucial to ensure that insurance companies reach their maximum efficiency while continuing to operate and run their core business. Aside from technical expertise, a Subject Matter Expert can use their healthcare business knowledge to understand the insurance company’s needs. With both the business and technical experience a Subject Matter Expert brings to the table, they can foresee issues and or challenges that might arise when mixing business rules with configuration.
This means that aside from helping you gain competitive advantage through maximizing the functionality of Facets™, SMEs can be an asset to you and your company when forced to continue to meet City, State and Federal Government changes within the healthcare Industry.
Experience and Expertise
A Subject Matter Expert brings experience and knowledge to your Facets™ project that most insurance companies may not possess. While your company may only implement a new claims administration system once every 5 or 10 years, with Facets™ you are mandated to keep up with upgrades and install patches at a minimum of once a year due to contractual agreements when purchasing Facets™. Given their familiarity with Facets and numerous first-hand experiences to various issues that can possibly arise during the configuration and testing stage, SMEs can help insurance companies execute and complete the project without disrupting business.
Executing a Facets™ project with little to no experience can put a company at risk which could compromise an entire project.
Subject Matter Experts provide a different perspective to a project. With their significant understanding of Facets™, an SME will help improve the efficiency of your operational process. For instance, depending on your current infrastructure, a consultant can advise if Facets™ should be deployed in-house, hosted by TriZetto or be outsourced by a 3rd party. A Subject Matter Expert provides insights on which type of deployment option is best suited for both your department and your company.
Proven Project Methodology
With their vast experience, SMEs are equipped with a proven step-by-step process that includes a library of what works and doesn’t work from their past projects to help assure the success of your Facets™ project.
A crucial part of any project is conducting a full analysis by sitting down with both the Business and the Technical stakeholders. Typically, this is done by working with your staff so that the objectives and the requirements of the business are met. Although you might be installing “just a patch”, Facets™ must be tested from an E2E (end to end) stage - from submitting claims through the gateway, to receiving an EDI Claim, eligibility, membership, billing to finance all the way until a check is generated and the “test” provider is paid.
Subject Matter Experts can provide an accurate analysis to the upper management of your business to assist them in creating a strategic and informed decision. Facets™ consultants can also give an objective input on management/support staff capabilities.
Significant Cost Savings When Configured Properly
By implementing and configuring Facets™ properly, you will certainly reap significant cost-savings. They assist you in documenting the requirements of your business and apply those in the design, build and testing of Facets™ configuration, enabling you to create new products with great value and deliver it to your market more quickly.
Subject Matter Experts ensure that timeframes and budgets are met, from the beginning test stages of System Integration, to Unit / User Testing all the way to End to End Testing. This allows you to achieve your business goals in a timely manner.
All in all, using a Subject Matter Expert will result in a more efficient, accurate, quality configuration and maintenance of your company’s core and integrated system, ensuring that every dollar spent on the project are maximized.
In conclusion, having a Subject Matter Expert is a valuable extension to your company during the configuration and testing phase of Facets™.
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