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New Operating Models to Heal

ADAPT PROCESSES
TO READ YOUR
CUSTOMER’S ‘PULSE’

Engaging with patients on their terms helps drive better outcomes.

ENHANCE EXPERIENCES AND OUTCOMES


Digitizing healthcare processes puts the focus of operations back to where it should be—on patient care.

While various segments of the healthcare market—from payers to providers to pharmacy benefits managers—may have different types of customers, a precise, hyper-personalized focus on those customers is central to fuel all of their digital business success.

Adaptable and agile operating models and processes are key for healthcare players to succeed in a challenging market where they must grapple with industry forces such as accountability, risk re-allocation, cost of care, consumerism and the robust regulatory environment all while trying to innovate and grow while managing costs.

Cognizant brings together the automation insights and ready-to-deploy, best-in-class processes and platforms that healthcare companies require to move their operations closer to customers to provide the personalized engagement they demand.

As a result, businesses are freed from managing cumbersome processes that do not set them apart in the market and drain their resources to instead create new products, focus on customer experience and build a strong competitive differentiation.

LATEST THINKING

SERVICES

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 offering 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.

  • PAYER SERVICES

    BRING DIGITAL TO LIFE

    We help you evolve to meet the demands of constantly changing industry environments, shifting customer needs and the rapidly-transforming technology landscape. Our offerings include:

    • Product Design and Sales
    • Enrollment
    • Billing
    • Provider Network Management
    • Claims
    • Medical Management
    • Customer Services
    • Reporting and Analytics
    • Corporate Functions
  • REVENUE CYCLE MANAGEMENT (RCM) AND PROVIDER SERVICES

    FOCUS ON CARE AND PATIENT SATISFACTION

    Our RCM and provider services include:

    • Hospital RCM
      Our solutions address hospital needs for improved metrics, accelerated cash flow and improved patient satisfaction and include:
      • Services designed to fit the ever-changing needs of the hospital system.
      • Comprehensive Accounts Receivable management process supported by best-in-class workflows and proprietary software.
         
    • Provider RCM
      Our complete revenue cycle solution for large multi-specialty practices and niche specializations alike includes:
      • Service options with full spectrum outsourcing to system conversion projects.
      • Practice management for those groups that want to focus solely on the practice of medicine and leave the business of medicine to Cognizant.
         
    • Third Party Liability
      Our intelligent software suite helps handle difficult and complex reimbursement cases including identification and recovery. The suite also provides:
      • An end-to-end solution that encompasses determination, lien filling, negotiation and recovery.
      • Personal injury protection (PIP), medical payment (MedPay) and third-party liability.

    Other RCM and provider services include:
    • Self-pay
    • Eligibility
    • Denials
    • Clinical Coding
    • Collections
    • Government RCM
  • BPAAS FOR PAYERS

    REDUCE COSTS, IMPROVE PRODUCTIVITY

    Cognizant’s wide-ranging BPaaS portfolio puts us in a unique position to provide superior BPaaS solutions to payers.

    Our services increase payer efficiency, build strategic business agility, improve productivity, reduce costs, mitigates risks and positions payer business for growth.

  • GOVERNMENT BPAAS PROGRAM

    BOOST HEALTH OUTCOMES AND COMPLIANCE

    Our acquisitions of TriZetto and TMG Health create a portfolio of capabilities with a BPaaS framework that can be quickly and efficiently deployed to meet the complex data processing and compliance requirements of Medicare Advantage, Managed Medicaid and Medicare Supplemental plans promptly.

    These services increase regulatory compliance and error-free submissions, while reducing operational costs and improving health outcomes.

AS-A-SERVICE MODELS

STAY AGILE IN A VOLATILE MARKET


“As-a-service” models are not only changing how businesses invest in modernizing technology, but are also providing the necessary operational agility to expand as the market grows. Cognizant melds automation, insights and best-in-class industry processes to allow businesses to create new products and focus on customer experience for a strong competitive differentiation.

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NEWS

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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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