Trizetto Facets Documentation

Today, Facets is the most widely used core administrative processing system. Facets process hundreds of millions of transactions every week for more than 80 health plans with over 170 million members, so it's easy to think of it as reliable rather than revolutionary. Facets are, in fact, both. By continuously, intelligently, and strategically developing the technology to take full advantage of the newest advancements in software design, architecture, and deployment, that made an industry leader. This tutorial is intended to provide the whole knowledge of the core administration system of TriZetto Facets. Let’s start with Facet’s voyage.

The voyage of the Facets


Facets have evolved from “bare metal” through virtual machines to today's cutting-edge containerization technologies since its start. Through the technology investments we've made thus far, we're starting to see the advantages of the 6th generation of Facets.

First Generation: 

  • The first release of Facets for Microsoft Windows. 
  • Sybase RDBMS.
  • AIX.
  • HP/UX.

Second Generation:

  • Parallel processing.
  • Extensibility of database schema restructuring.
  • COM service API.
  • MS SQL DBMS.
  • 1MM scalability.

Third Generation:

  • Simplifying the platform (Windows).
  • Facets regions / logical instances in distributed processing architecture.
  • UX revisions.

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Fourth Generation:

  • SOAP APIs.
  • Workflow.
  • System telemetry.
  • Web content supports extended dispersed processing UX revisions.
  • Oracle DBMS.
  • 5MM scalability.

Fifth Generation:

  • Model of agile development.
  • REST API.
  • ARCSS stack of technologies.
    Extended distributed processing on the cloud revisions to the UX.

Sixth Generation:

  • Web-based UX Facets 360. 
  • Insights into Facets Big data platform with AI/ML.
  • IoT.
  • Cloud-optimized.

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Containers, Cloud, AI production scale, and more


We've accompanied our clients on this journey, providing them with cutting-edge tools and capabilities while reducing their total cost of ownership and speeding up their operations. Facets cater to a wide range of clients, from those with 50 million to those with less than 100,000.

The Facets clients, regardless of their size, benefit from technology such as:

Cloud: 

The most recent Facets generation was created in and for the cloud. We don't use the cloud as an add-on; it's our primary development environment. Facets have been designed to take full use of cloud computing's scalability and flexibility. However, because we are vendor-neutral, our clients may use any public, private, or hybrid cloud environment, as well as a combination of on-premise and cloud.

Containers: 

Using container technology, we keep Facets light and portable. Our cloud-ready containerized runtime provides excellent user experiences, accelerates development, and reduces costs by making effective use of computational resources.

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Machine learning and Artificial intelligence

Facets were developed with AI and machine learning capabilities to automatically offer insights to clients based on their system's huge data repositories. System health, user performance disparities, and real-time support to service agents as they interact with members are all examples of insights.

Fundamentals of production
Facets have demonstrated their ability to produce outcomes in real-world, high-demand production situations on a multichannel, 24/7 basis. Furthermore, we run Facets through a series of performance tests using a setup that is representative of a big customer. Through a technological stack intended for intelligence, scalability, and accuracy, we gain the power and dependability to process tens of millions of transactions each day.

Facets' technological stack combines cutting-edge technology with industry best practices. This stack is used to build each Facets module, resulting in highly responsive single-page apps.

How are Facets created in the ARCSS stack?

  • Angular TypeScript-based open-source web application platform is used as the foundation for single-page applications.
  • RESTful architecture pattern using the stateless protocol and standard operations, contributing to the highly responsive single-page applications and runtime engine.
  • C++ Complex mission-critical applications require mission-capable technology, so all of Facets' heavy computing is done in a C++ high-performance natively compiled business runtime engine. This is key to how Facets scales.
  • SQL-based RDBMS such as Microsoft SQL Server, Oracle Exadata, or Oracle Enterprise.
  • Streaming is accomplished with a high-performance NoSQL format. This strategy supports Facets' event-driven architecture and ability to subscribe to IoT data streaming patterns. Facets may bring in events through REST APIs to fuel applications within and outside of Facets with data.

Runtime in containers


We use containers for our runtime services because they provide the best flexibility and performance. We've implemented the industry's most advanced container orchestration solution. To control cost and security, our containerized runtime may make use of features like auto-scaling and the usage of policy settings to govern resource utilization.

Client Layer
Thin client: Single-page apps, zero-footprint, and a rich responsive experience are all available.

AI/ML: Improve member and provider experiences by incorporating probabilistic reasoning into transaction processing.

The client layer can be operated by using the following:

  • Angular
  • HTML5
  • Google Chrome
  • Chromium Embedded Framework
  • Chart.js

Application Layer
RESTful APIs: Provide a lightweight, adaptable, and scalable language Franca that is easy and natural.

Runtime advances: Orchestration and Containers; security advancements, elasticity.

The application layer can be operated by using the following:

  • Python
  • Kubernetes
  • .NET Core
  • C++
  • Scikit Learn

Data Layer
Data Streaming: For real-time digital operations, Facets includes high-performance message storage, data publication, and IoT messaging.

The application layer can be operated by using the following:

  • Windows
  • Oracle
  • SAP
  • Linux
  • Kafka

Containers allow us to provide customers with a variety of deployment choices by abstracting the program from the infrastructure it runs on. This enables us to support a wide range of operating systems and improves system portability, even between cloud providers. Clients can also use containers to install several instances of Facets for testing, pilot projects, or data segregation.

Filling the pipeline for continuous integration or delivery
Containers enable us to create new Facets features and apps faster, allowing us to remain ahead of the healthcare industry's ever-changing compliance and business needs.

The cadence of regular release
Our quarterly development cycle ensures that new functionality and compliance-related upgrades are delivered on schedule. Client acceptance of new functionality is aided by low-friction updates and passive adoption techniques. The adoption cadence that best meets the client's business needs is determined by the client.

User-centered design
The software development is influenced by our clients, members, and providers. The development teams include human design experts with deep product knowledge. User testing and field trials give vital data that allows each design to be fine-tuned before it is released.

Delivery models with low friction
Facets' release pipeline provides clients with deliverables that are simple to incorporate into their own CI/CD workflows. This method makes it simple to introduce new features into their surroundings.

low friction

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ML, AI and IoT Incorporation with Facets Insights
Facets Insights is an integral element of the Facets transaction processing system, providing probabilistic capabilities to assure the best possible transaction outcomes. This could compare activities to models and offer suggestions, and also perform rules-based actions in real-time.

Facets produce and consume massive quantities of data. When a single claim is handled, 1,000+ IoT-style messages are generated; this increases by millions of claims processed, and the result is a massive amount of IoT-style communications.

Insights of Facets
Facets Insights can estimate the possibility of a member quitting the plan using machine learning models and propose a solution to the service person engaging with that member. Facets Insights could estimate the possibility of a member quitting the plan using machine learning models, and then propose a solution to the service professional who interacts with that member. Identifying rejected claims that will be reviewed and not discarding them to save rework and member disappointment is one example.

Closed-loop feedback
Facets are always learning and developing due to its closed-loop feedback mechanism, which has resulted in:

  • Optimization.
  • Increased accuracy.
  • Fewer errors.
  • Increased stability.
  • Calibrated sensitivity to events.
  • Increased resilience to disturbances.
  • Reliable and repeatable performance.

Leading-edge security and Real-time processing


Processing in real-time
Facets Data Publishing is a data streaming platform that uses an event-driven design. In real-time, the system distributes information regarding claims, members, and providers. The system is adaptable: clients can use batch or real-time procedures to consume or publish data. Facets deliver data as it changes or as it is requested in the latter case. Facets data and custom data are both included in publishing entities.

Security on the leading edge
Facets incorporate security into the software development life cycle at every level, recognizing and resolving possible security issues while adhering to industry best practices and compliance requirements. We support open protocols such as OpenID, OAuth2, and JWT for pluggable federated authentication. Facets maintain authorization using a set of role-based and application-layer controls. Data encryption at rest and in flight, and also full auditing capabilities for all system and user activity and data changes, are among the other features.

Enrollment

Member enrollments and real-time group.

  • ID card requests
  • Members can use self-service to update their demographic and contact information.
  • Enrollment data can be added or updated by agents or groups.

Customer Service

  • Real-time interfaces with Facets allow CRM systems to manage customer support activities.
  • Workflow management in customer service.

Billing

  • Billing operations in real-time.
  • A detailed billing summary is provided.
  • Future bills.
  • Invoices and Payments.
  • Requests for billing.

Interoperability

  • New models, players, and consumer demands for an integrated perspective and access are all being driven by digital disruption.
  • B2C/B2B connectivity.
  • ONC/CMS pending interoperability regulations.

Claim Processing

  • Allows trade partners and suppliers to file and manage claims in real-time.
  • Estimates of future costs.
  • Data quality and Auto-adjudication have both improved.

Customer Transparency

  • A set of APIs increases the number of ways to improve auto-adjudication.
  • Eligibility, benefits, and cost estimate transparency solutions for consumers.

Open, Modular, and Expandable


Modern healthcare organizations with Leading-edge technology
Every day, Facets shows its worth in the real world. Facets maintain the flexibility, features, and scalability that over 80 healthcare organizations rely on to serve their members, from member enrollment and billing to claims processing and care management, thanks to our commitment to incorporating best-in-class cloud, containerization, security, AI, and interoperability technologies.

Facets provide our clients with unrivaled versatility, including extensibility, due to its cloud-based architecture, REST APIs, and container technologies. Facets logic can be extended or replaced as needed by clients. Platform adaptability is important. All major cloud providers are supported by us. Options for deployment The architecture of Facets is modular. Clients can select any components that fit their existing business needs, such as registration, billing, and claims. Clients just require the correct license key to add modules. Each module is tightly linked while remaining integrated.

Extensibility
Facets logic can be extended or replaced as needed by clients.

Platform flexibility
We work with all of the main cloud providers.

Deployment options
Facets are built on a modular system. Clients can select any of the components—enrollment, billing, claims, and so on—that fit their existing business requirements. Clients simply need the proper license key to add modules. Each module is tightly linked while also being integrated.

Modern healthcare organizations require cutting-edge technologies
Every day, Facets shows its worth in the real world. Our commitment to incorporating best-in-class cloud, containerization, security, AI, and interoperability technologies ensures Facets maintains the flexibility, features, and scalability that more than 80 healthcare organizations rely on to serve their members, from member enrollment and billing to claims processing and care management.

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Conclusion

In this tutorial, we have discussed the Facets’ journey with generations, the technologies that benefit from the cloud, containers, artificial intelligence, and machine learning. The Facets insights of data by using AI, IoT, ML were also discussed along with production fundamentals, run time processing, and leading-edge securities like processing claims, interoperability, etc. We hope this documentation has provided sufficient knowledge for the aspirants which also have included the support for modern healthcare organizations with cutting-edge technologies.

Related Articles: What is Facets

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Manikanth
Manikanth
Research Analyst
As a Senior Writer for HKR Trainings, Sai Manikanth has a great understanding of today’s data-driven environment, which includes key aspects such as Business Intelligence and data management. He manages the task of creating great content in the areas of Digital Marketing, Content Management, Project Management & Methodologies, Product Lifecycle Management Tools. Connect with him on LinkedIn and Twitter.