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13 TriZetto QNXT Reviews
Best thing about QNXT is it is getting upgraded as per new trends and adopt new things easily.
It is secured and all things like starting from enrolling a member, provider till the last step of claim settlement and be done within a single application. Review collected by and hosted on G2.com.
Many times user faces the latency while surfing through application in the pick time.
Also the audit or history do not store detail records. Only the last changes can be seen, it is expected that whenever there is any changes to the record it should show which all fields were change each time. Review collected by and hosted on G2.com.
For EDI reporting and tracking, the QNXT database and the way it's structured makes it easy to effectively conduct research and provide resolutions for client issues with custom reporting. Reports generated from within the QNXT application. As well, the backend data can be used in conjunction with error logs which provides data downstream for the Executive Dashboard by developing a new MS Access Benefit Load and Tracking Database. As well, a great platform which makes it a straightforward process to effectively troubleshoot incidents errors in 837 and 835. The QNXT database integrates nicely when you write and run SQL queries on Oracle or SQL Server database table joins with QNXT. Review collected by and hosted on G2.com.
QNXT is great at pricing claims, administering members, and managing billing. The issues are with having to adapt to new requirements in processing. For instance, it’s difficult to do a member lookup and replace before processing. QNXT intakes 837 claims files and EDI 834 enrollment files using Microsoft BizTalk Server. The files are translated from EDI to XML within BizTalk’s native EDI parsing pipeline component deployed as part of QNXT’s ‘QNXT Connect’ BizTalk Application. QNXT receives the XML where it is carried through it’s modules. However, it is often the case that custom logic is necessary to ensure the success of the message within QNXT. This can be due to:
Enrichments or lookups necessary to the file, such as the previously mentioned need for a member lookup and replacement
Conditional routing based on success or failure of the file
Pre-validation to prevent a single failed record from causing failure of the entire transaction set
Typically there are two ways to allow for the application of custom logic within a QNXT implementation – applications deployed in BizTalk, or custom agents deployed in QNXT.
Developing BizTalk applications, while very robust and flexible, require an advanced skill set to employ effectively. Not only does a developer have to know BizTalk, but also have a high degree of knowledge of XML in order to properly ‘work’ with the EDI. BizTalk does not supply out of the box APIs to ease the EDI development burden when working with healthcare data.
Looking back at the scenario of member lookups, a BizTalk application would have to be created that would perform member lookups and replacements. This however, would require knowledge of XPath navigation of the XML schemas used by BizTalk to update the member fields.
QNXT agents can be developed in C# .NET, and easily deployed using a QNXT provided deployment wizard. These agents can be positioned to execute prior to processing (Pre Agent) or post-processing (Post Agent). An executing agent has access to an XML representation of the EDI data received by QNXT, whether claims, enrollments or other data sets.
Using an agent negates the need for specialized BizTalk knowledge, however presents several limitations that have to be overcome:
XML: EDI is presented as XML within another XML wrapper containing file specific metadata injected by many layers of nesting and knowledge of XPath may present difficulty in developing an agent.
Testing: Testing custom pre and post agents requires either attaching a debugger to QNXT or careful interpretation of log entries within the QNXT process log browser.
Tracking: QNXT only surfaces the start and end of a custom agent’s execution, with only basic record counts and a success/failure logged.
Maintenance: There is a wizard provided to deploy agents, however custom built agents may need frequent updates to ensure compatibility as new QNXT versions are deployed.
QNXT Pre and Post agents' custom steps do not have access to the full X12 EDI message and a robust EDI parser, validator, splitter among its API tools. This is helpful in allowing seamless editing and resubmission of problem claims or enrollments.
Preprocessing EDI files within an existing TriZetto QNXT implementation remains a challenge in some cases. Review collected by and hosted on G2.com.
I really like TriZetto QNXT‘s front end and user experience. It is very integrated with my other softwares and pairs nicely with our workflows. Review collected by and hosted on G2.com.
I dislike how TriZetto QNXT has limited features and mobility. I would like to see that built out a little more. Review collected by and hosted on G2.com.
QNXT is an all in one solution for the healthcare insurance industry. All your functions in one big and responsive data base. Review collected by and hosted on G2.com.
Better reporting services from QNXT, an integration to other reporting tools. Review collected by and hosted on G2.com.
Qnxt application delivers the flexibility and functionality necessary to improve performance and increase efficiency. Review collected by and hosted on G2.com.
Qnxt has limited features and mobility, I would like to see that built out a little more. Review collected by and hosted on G2.com.
