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Operations On Demand

STREAMLINE YOUR BENEFITS FUNCTIONS AND BOOST CUSTOMER SATISFACTION

Benefits Administration Services that supplement your existing business operations, when and where you need them.

SUPPORT STRATEGIC INITIATIVES


Keep your benefits administration processes running like clockwork all year long, even during busy enrollment periods.

Many day-to-day benefits administration functions can be time-consuming and employee-intensive. Processes like enrollment, billing and claims administration need to be performed as efficiently as possible to maintain profitability and ensure client satisfaction. In addition, there may be times when you need to supplement existing resources due to rapid business growth, busy enrollment periods or staffing shortages.

TriZetto's Benefits Administration Services offer an efficient and cost-effective means of supplementing your existing business operations or addressing an immediate need situation. We have the software, technology, expertise and proven methodologies to help you streamline inefficient business functions, keep your operation running smoothly and deliver enhanced service to employers, providers and plan members.

Our TriZetto Healthcare Products teams have extensive knowledge and experience in both healthcare IT and benefits administration, and offer the following services in support of your strategic business and operational needs.

  • Application Management Services

    Focus on client-facing core competencies, while your IT infrastructure and application management functions are expertly maintained. Gain guaranteed performance; an optimized infrastructure; and hosting and management expertise in support of your QicLink™ core administration system and other critical applications—all for a cost-predictable monthly fee.

  • Business Management Services

    Improve operational effectiveness and respond to changing benefits administration requirements with a full complement of technology and administrative service solutions. Select as many or as few services as are right for your organization. Then, choose whether you would like our professionals to fully manage and operate the service or provide connectivity to your team—all within a highly secure, HIPAA-compliant environment. 

    • Claims Data Intake Services: These services provide mailroom, scanning/OCR, data entry and correction, and EDI claims intake support that will free up your team for client facing business processes.
    • Claims Adjudication Services: Offload labor-intensive claims adjudication, claims payment adjustments, plan building and provider maintenance functions to qualified professionals.
    • Claims Overflow Services:  Accommodate those instances where your in-house team is temporarily overburdened and you are in an overflow situation. Highly qualified personnel can help you manage backlog, cover vacation time, relieve overtime situations, quickly implement new accounts and provide additional support during open enrollment.
    • Claims Continuity Services:  In the event of a disaster, get back to faster with claims continuity services that cover more than annual recovery testing and off-site storage. Trained QicLink™ claims processors can perform those functions critical to your business using your own policies and procedures. Client, member and provider satisfaction will be maintained while you get your business back up and running.
    • Customer Service: Member and provider calls can tie up resources. Our trained customer service professionals are available to deliver support 24/7, aided by Constituent Web Portal and Interactive Voice Response (IVR) technology that can be integrated with your TriZetto QicLink™ application.
  • Consulting Services

    Optimize the value of your TriZetto QicLink™ core administration solutions. Consultants with both product and healthcare industry experience can help you realize quantifiable gains in productivity, profitability and client satisfaction. Optimize the return on your IT investment and leverage your system's capabilities with one or more of the following:

    • Custom Programming Services to produce specialized formats, views and reports, or create new functionality.
    • Training Services to ensure your staff is deriving full value from your technology.
    • Implementation and Integration Services to drive a successful, efficient system implementation and integration of pre-existing data and/or third party tools.
    • Business Performance Services for full utilization of current system functionality and improvements in automation, connectivity and web-enablement.

PRODUCTS

Core Administration

Increases payer efficiency, improve productivity, reduce costs and position your business for growth.

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Care Management

Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.

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Health Tranzform™

Enables shared decision making, communication and collaboration as a multi-channel, modularized solution.

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Provider Network Management

Automates pricing scenarios to provide the best value to payers, providers and patients.

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Quality Management

Enables payer/provider collaboration to reduce costs and drive overall quality improvement.

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Trading Partner Management

Manages EDI trading partners with one cost-effective, cloud-enabled technology service.

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Portal Technology

Automates transaction processing and information exchange between payer organizations and their external constituents.

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Optimization Tools

Automate and simplify operational tasks associated with our core healthcare technology solutions, Facets and QNXT.

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TriZetto® Elements™

Extend the functionality of your core system by providing critical capabilities from enrollment through risk adjustment, to efficiently administer government solutions.

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RELATED SERVICES

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Unparalleled healthcare business consulting expertise.

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Leverage the power of next-generation technologies to build a stronger, agile business.

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Infrastructure Services

Services to manage your infrastructure so you can manage your business.

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IT Professional Services

Unrivaled resources and healthcare expertise to meet your IT business needs.

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HEALTHCARE VISION BLOG

The Healthcare Vision Blog is a thought leadership forum that highlights our expertise and perspectives on healthcare strategy, government programs, operational excellence, population health management, digital transformation and other topics healthcare organizations are facing in a changing healthcare industry.

We invite you to read the blog, engage in the conversation around the topic and subscribe to be a member. When you subscribe, you will receive automatic notifications when there is a new blog post.

We look forward to your participation.  

VISIT OUR BLOG

CONTACT US

At Cognizant, we are here to provide you with more information about our TriZetto Healthcare Products software and service solutions and answer any questions you may have.

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Thank you for your interest in Cognizant.

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