Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.
Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.
Enables shared decision-making, communication and collaboration as a multi channel, modularized solution.
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.
Automates transaction processing and information exchange between payer organizations and their external constituents.
Automate and simplify operational tasks associated with our core healthcare technology solutions, Facets and QNXT.
Extend the functionality of your core system by providing critical capabilities from enrollment through risk adjustment, to efficiently administer government solutions.
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 needed to administer an individual line of business and participate in public and private insurance exchanges.
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.
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."
Share your success by nominating your organization for a Healthcare Excellence Award. Clients’ nominations will be recognized at the 2019 conference. Winners will be announced in the categories of excellence in innovation and operations. Let this be the year your organization is recognized. Join the ranks of previous finalists and winners. To learn more about the nomination process, contact the program manager.LEARN MORE