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Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.
Offers end-to-end solution that pairs modular SaaS products with industry-leading strategic consulting to connect disparate systems, standardize data and enable secure, authenticated access in real-time.
Streamlines workflows, reduces costs and improves outcomes by connecting and extending healthcare data from across your organization in real-time with TriZetto® TranZform®.
Automates pricing scenarios to provide the best value to payers, providers and patients.
Enables payer/provider collaboration to reduce costs and drive overall quality improvement.
Manages EDI trading partners with one cost-effective, cloud-enabled technology service.
Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.
Automates and simplifies operational tasks associated with our core healthcare technology solutions, Facets and QNXT.
Extends the functionality of your core system by providing critical capabilities, from enrollment through risk adjustment, to efficiently administer government solutions.
Automates transaction processing and information exchange between payer organizations and their external constituents.
Comprehensive, flexible and scalable core administrative solutions that enable the digital transformation required for success in the commercial market.
Support for the economic advantages and efficiencies.
Flexible IT solutions to address requirements with customizable functionality.
Functionality that adapts to meet the complexities and demands of the Medicare Advantage market.
Functionality that adapts to meet the complexities and demands of the Managed Medicaid market.
Flexible solutions to coordinate multiple compliance requirements and ease administration burdens.
Facets, an industry-leading core administrative processing system, incorporates powerful modern technology and best practices to deliver results in real-world, high-demand production environments, 24/7. Facets maintains the flexibility, features and scalability that more than 80 healthcare organizations rely on to serve their members.LEARN MORE
Kern Health Systems required modern technology to support its dramatic expansion and had to implement the solution within a tight timeframe. Alan Avery describes the details of the company’s success, including, “The reason we chose TriZetto was we believe they do have the people; they have the horse power; they have the strategy; they have the plan for the future.”
Affinity Health Plan discusses how working with both Cognizant and TriZetto consulting services was key in transforming claims operations for reduced backlog, lower adjustment requests, and increased auto-adjudication and accuracy. By the time the project was complete, providers were happier, employee morale was improved and a better business model was in place.
POMCO, a nationally based third-party administration firm serving approximately 600,000 plan participants, dramatically increased efficiency, accuracy and automation with TriZetto Solutions. Watch Nathan discuss, how working with TriZetto helped POMCO achieve a solution that could provide scalability, stability and flexibility to support his organization's rapid growth, resulting in increased claims automation levels of nearly 50% for every line of business.
Victoria Hurtado talks about working with Cognizant on Kern’s digital transformation journey. With the help of its Cognizant Systems Implementation team, Kern executed critical upgrades tied to meeting regulatory requirements and expanding auto-adjudication functionality. Victoria says, “The support we received from Cognizant was critical to the success of this project.”
El Paso First Health Plans, Inc., streamlined workflows, automated processes and enabled regulatory compliance with the TriZetto QNXT Appeals and Grievance Workflow solution. Sharon Perkins talks about how the company yielded 100% automation and cost savings. She says, "It automates a highly labor intensive process that was costing us time and money."