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Determining which party is financially responsible for services rendered is notoriously time-consuming and complex. The QNXT DOFR Module simplifies this process with a set of tools to easily define and configure individual Division of Financial Responsibility (DOFR) contractual relationships. This means they can be quickly and accurately analyzed and acted on during the claims adjudication process, and that claims can be paid by line of business, based on the DOFR. It also reduces gray areas in defining which party has risk for a specific service. Features include:
Appeals, grievance and complaint management
Streamline business processes with greater accuracy and efficiency
Fast, flexible integration of multiple applications
Align Division of Financial Responsibility (DOFR) payment with QNXT
Expanded automation of dental claims to increase efficiency and optimize workflow and accuracy
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.