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Streamline business processes with greater accuracy and efficiency.

Growing backlogs, dissatisfied providers and potential regulatory non-compliance issues are very real challenges for healthcare providers relying on manual workflows. QNXT Workflow outcome processing engines help reduce costs, improve operational efficiency and increase automation by helping to prioritize, triage and reduce pending and exception claims as well as utilization management inventory. 

  • QNXT™ Claims Workflow™

    QNXT™ Claims Workflow™ helps healthcare organizations manage claim inventory more efficiently by automating the process of prioritizing, triaging and reducing pended and exception claims. The result is streamlined claims adjudication management, reduced costs and improved speed, accuracy, efficiency and compliance. Features include:

    • Automatically manages and routes claims in real time to user work queues based on configured routing rules
    • Automatic identification, prioritization and routing of work items based on specific data elements, user skills, lines of business and other variables
    • Real-time delivery of work items
    • Real-time views of employee work queues
    • Natural language configuration of end-user desk-level procedures
    • A real-time online dashboard provides snapshots of workflow status that show projected workloads by user or role
  • QNXT™ Utilization Management Workflow

    Designed to help plans manage the inventory of Utilization Management (UM) documents, QNXT™ Utilization Management Workflow helps healthcare organizations prioritize, triage and reduce lagging pended UM or referral requests. The result is improved efficiency, reduced costs, and enhanced supervisor and staff productivity. Features include:

    • Automatic identification, prioritization and routing of UM documents to end users
    • Real-time delivery of work items via seamless integration with QNXT™
    • User-configurable UM queues
    • Real-time views of employee utilization and work queues
    • Natural language configuration of end-user desk-level requirements
    • Prioritization of UM items to meet timely resolution and compliance requirements

QNXT MODULAR ADD-ONS

QNXT™ Appeals and Grievance Workflow™

Appeals, grievance and complaint management

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QNXT™ Claims Workflow™

Streamline business processes with greater accuracy and efficiency

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QNXT™ EXtended Integration™ (QXI)

Fast, flexible integration of multiple applications

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QNXT™ DOFR Module

Align Division of Financial Responsibility (DOFR) payment with QNXT

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LATEST THINKING

Solution Summary
TriZetto® QNXT Claims Workflow™

Streamline Business Processes with Increased Accuracy and...

Solution Summary
TriZetto® QNXT™ Utilization Management Workflow

Automatically Manage and Route UM Documents in Real-Time to...

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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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