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Increase Agility, Reduce Costs

Transform operating models to improve patient outcomes

Learn why 20 of the top 25 U.S. health plans work with us.

UNIFY THE HEALTHCARE ECOSYSTEM

Today’s healthcare companies must drive better patient outcomes and manage consolidation while evolving operating models and reducing administrative costs across the healthcare ecosystem.

To succeed, payers and providers need combined clinical, business and process expertise along with intelligent digital platforms to create efficient and agile operations. Cognizant provides business process transformation and managed services across the healthcare ecosystem. We leverage cloud, data, automation, AI and our industry leading Trizetto digital healthcare platform to develop and manage intelligent and adaptable operating models. This results in improved efficiencies, responsiveness and ability to unify the healthcare ecosystem.

The Future of Infectious Disease

Discover how advanced technologies and significant changes can help us mitigate the impact of global health crises like COVID-19.

READ MORE

SEGMENTS

Payers

Implement managed services, automation and AI to streamline claims management to reduce cost and regulatory risk as well as improve efficiency and intelligence.

Providers

Apply business process transformation to better coordinate, deliver and manage quality care while improving patient centricity to drive profitable growth.

Pharmacy Benefit Managers

Combine intelligent digital platforms and managed services to improve regulatory compliance, clinical management programs and business intelligence.

50%

reduction in operational costs in healthcare companies through business process transformation

OFFERINGS AND PLATFORMS

TRANSFORM CARE WITH NEW OPERATING MODELS

With new digital operating models, healthcare companies can focus on enhanced consumer experiences and healing. Our services underpin the success of a new healthcare business model built on the features, functionality and value that consumers find indispensable.

Our deep relationships with leading healthcare organizations around the world put us in a unique position to deliver services through our integrated model, where we focus on the industry trends that are sustainable while investing in areas that drive fundamentally better outcomes at lower costs.

COGNIZANT® DIGITAL HEALTHCARE PAYER

BRING DIGITAL TO LIFE

Evolve to meet the demands of constantly changing industry environments, shifting customer needs and the rapidly transforming technology landscape. This results in reduced costs, greater flexibility and growth generation.
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COGNIZANT® MEDICAL DEVICES REVENUE CYCLE MANAGEMENT

IMPROVE QUALITY. REDUCE COSTS

Modernize your claims submission process and provide real-time visibility into key metrics across your revenue management ecosystem. With our expertise, automation and analytics tools, we help your organization recoup lost revenues.
LEARN MORE
BUSINESS PROCESS AS A SERVICE (BPAAS) FOR PAYERS AND GOVERNMENT PROGRAMS

REDUCE COSTS AND RISKS

Increase payer efficiency and growth, build strategic business agility, improve productivity, reduce costs and mitigate risks with our comprehensive BPaaS portfolio.
LEARN MORE
COGNIZANT® INTELLIGENT PROCESS AUTOMATION

WHY IPA?
GREATER ROI

Elevate workforce productivity by automating specific functions as well as end-to-end business operations. Leveraging leading automation platforms, we partner with you to improve workforce productivity and streamline customer experiences to drive business performance and growth.
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COGNIZANT® DIGITAL FINANCE AND ACCOUNTING

DIGITALLY TRANSFORM FINANCE AND ACCOUNTING

Transform finance and accounting operations into a value generator for your organization. Apply next-generation digital capabilities to enhance existing investments and turn procure-to-pay, order-to-cash, record-to-report and financial planning into valuable business insights.
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COGNIZANT® DIGITAL CUSTOMER SERVICE

TREAT YOUR CUSTOMERS RIGHT

Achieve new revenue-generating opportunities for your organization with next-generation customer service. We enable you to deliver proactive, predictive interactions across all your customers’ preferred channels to deliver more efficient, effective and enriched experiences.
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LATEST THINKING

PERSPECTIVES

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HEALTHCARE

BPaaS Solution Improves Health Plan’s Financial Wellness

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The Challenge

A major U.S. healthcare organization with more than one million members in its government programs had difficulty modernizing the systems and capabilities required to comply with the emerging regulatory requirements of the Centers for Medicare and Medicaid Services. Its systems were outdated and expensive. Low automation rates, extensive manual processes and non-standardized data structures resulted in inadequate claims processing turnaround times and claims pricing inaccuracies. Antiquated customer service tools and minimal interactive voice response capabilities resulted in poor user experiences that hurt the brand and its standing with CMS.

The payer turned to Cognizant's healthcare technology experts for a comprehensive yet cost-effective solution that would solve its immediate need for a modern, end-to-end solution and provide a foundation for thriving under value-based care.

Our Approach

We deployed our Business Process-as-a-Service (BPaaS) solution for government programs, delivering a comprehensive TriZetto Facets core administration platform as a hosted service operated by Cognizant and overseen by the client. To begin with, Cognizant addressed the root causes of claims and encounter issues by collaborating with the payer’s senior operations executives and drawing on their extensive experience in government health plan administration. Facets enabled streamlined maintenance, standardized processes and improved system capabilities to reduce claims backlog. The solution also enhanced provider-matching rates by 3% to 4%, eliminating the chances of authorization rejection by plans due to invalid procedure codes.

A separate project introduced the Encounter Data Management module of Facets. It not only improved encounter utilization monitoring acceptance rates from 83% to 92% in just a month but also enabled the submission of more than $450 million in backlogged encounters, improving the payer’s revenue stream. Automating HIPAA authentication and self-service claims helped reduce call volume by 15% and call time by 30 seconds for remaining 51% of the call volume.

Facets Core Administration Solution Boosts Revenue Streams

Cognizant helped the healthcare payer meet regulatory compliance levels and position itself for success under a value-based care model and emerging mandated interoperability requirements by improving processing speed and data accuracy. Integrating Facets features like NetworX Pricer helped the client achieve over 99% pricing accuracy through automation. We not only helped the payer enhance member and provider experiences but also boost its revenue.

SEE THE FULL STORY »

25%

reduction in plan administration TCO

15%

reduction in call volume

99%

claims pricing accuracy

Healthcare Business Process Automation Solutions PEAK Matrix™ Assessment 2019

Digital solutions play a critical role, and automation (RPA and AI) has garnered considerable mindshare. Benefits of implementing automation solutions include cost savings, enhanced customer experience and quality, revenue growth, better population health, improved speed, security and governance.

READ MORE

Cognizant Digital Operations: Healthcare

Learn how Cognizant helps you unify the healthcare ecosystem, manage consolidation, and reduce administrative costs so you can focus on optimizing patient outcomes.

LEARN MORE

TAKE THE FIRST STEP

Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital capabilities is vast and growing.

Let’s talk about how digital can work for your business.

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COGNIZANT CONSULTING

COGNIZANT CONSULTING

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Key Themes

Center for the Future of Work

COGNIZANT CONSULTING

COGNIZANT CONSULTING

Our Media & Publications

Key Themes

Center for the Future of Work

Healthcare

Contact Us

Your information has been submitted successfully!

Transform operating models to improve patient outcomes

UNIFY THE HEALTHCARE ECOSYSTEM

Today’s healthcare companies must drive better patient outcomes and manage consolidation while evolving operating models and reducing administrative costs across the healthcare ecosystem.

The Future of Infectious Disease

SEGMENTS

Payers

Providers

Pharmacy Benefit Managers

50%

OFFERINGS AND PLATFORMS

TRANSFORM CARE WITH NEW OPERATING MODELS

BRING DIGITAL TO LIFE

IMPROVE QUALITY. REDUCE COSTS

REDUCE COSTS AND RISKS

WHY IPA?GREATER ROI

DIGITALLY TRANSFORM FINANCE AND ACCOUNTING

TREAT YOUR CUSTOMERS RIGHT

LATEST THINKING

VIEW

VIEW

VIEW

HEALTHCARE

BPaaS Solution Improves Health Plan’s Financial Wellness

The Challenge

Our Approach

Facets Core Administration Solution Boosts Revenue Streams

25%

15%

99%

Healthcare Business Process Automation Solutions PEAK Matrix™ Assessment 2019

Cognizant Digital Operations: Healthcare

TAKE THE FIRST STEP

Thank you for your interest in Cognizant.

We’ll be in touch soon.

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LATEST THINKING

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WHY IPA?
GREATER ROI