ELIMINATE MANUAL PROCESSES AND IMPROVE EFFICIENCY

Effective management of a dual-eligible health plan requires a highly-integrated, member-centric approach that eases the administrative burden due to labor-intensive, manual-based processes that circumvent their core administration system.

With deep experience in the Medicare and Medicaid markets—and over 40 clients managing dual eligibles—our technology and services solutions deliver improved care coordination to lower costs and improve quality. We do so by following a highly integrated, member-centric approach.

The Cognizant line of TriZetto Healthcare Products offers core technology that employs a single-solution approach to help plans manage costs and rapidly respond to changing CMS guidelines. Our solutions simplify administrative processes for complex dual benefit claims and encounters, and improve care coordination. The result: lower costs and enhanced quality.

Manage Your Population Effectively

Manage the administration of your Medicaid and Medicare Advantage population more effectively and efficiently with tools that allow you to:

• Converge benefits and pricing into a single claim that includes utilization management and adheres to CMS and Medicaid rules.
• Coordinate and improve care for high risk members.
• Administer distinct, provider network three-way agreements.
• Reduce manual processes with integrated member-centric functionality.
• Support business growth with a scalable solution.