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TriZetto Healthcare Products / Duals

Automate processes and improve efficiency

Effective management of a dual-eligible health plan requires a highly-integrated, member-centric approach that eases the labor-intensive, manual-based processes that circumvent your core administration system.
The Cognizant line of TriZetto Healthcare Products has deep experience in the Medicare and Medicaid markets with over 40 clients managing dual eligibles. Our technology and services solutions deliver improved care coordination to lower costs for better client experience. 
We offer core technology that employs a single-solution approach to improve cost management and rapidly respond to changing CMS guidelines. Our solutions simplify administrative processes for complex dual benefit claims and encounters and enrich care coordination resulting in lower costs and enhanced quality.
Manage your duals population effectively
Manage the administration of your Medicaid and Medicare Advantage Duals population more effectively and efficiently with our tools that:
  • Automate manual processes with integrated member-centric functionality.
  • Converge benefits and pricing into a single claim that includes utilization management and adheres to CMS and Medicaid rules.
  • Encourage business growth with a scalable solution.
  • Facilitate care for high-risk members.
  • Manage distinct provider network three-way agreements.

 

Products

Core Administration

Increases payer efficiency, improves productivity, reduces costs and positions your business for growth.

Cognizant Interoperability Solutions

Offers end-to-end solution that pairs modular SaaS products with industry-leading strategic consulting to connect disparate systems, standardize data and enable secure, authenticated access in real-time.

Provider Reimbursement Solutions

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

Quality Management

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

TriZetto® EngageMember®

Members may interact anytime, anywhere and receive a detailed view of their coverage information with compelling metrics, timely notifications and relevant healthcare content.

Business Process-as-a-Service

This integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

TriZetto® EngageProvider®

Enables physicians and other care providers to access detailed information on their patients, efficiently log claims and make templates for common claims, as well as easily create referrals and authorizations.

Trading Partner Management

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

Care Management

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

Optimization Software Products

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

TriZetto Elements®

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

Portal Technology

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

Related services

Business process services

Services that offer meaningful business outcomes.

Business consulting

Benefit from our unparalleled healthcare business consulting expertise.

Next-gen technologies

Put next-generation technologies in place that build a stronger, more agile business and lay the groundwork for future AI and automation initiatives.

Infrastructure services

Get services that ease the strain of managing your infrastructure so you can focus on managing your business.

IT professional services

Take advantage of our unrivaled resources and healthcare expertise to meet your IT business needs.

Services/Benefits administration

Apply our proven software, technology, expertise and tested methodologies to manage your business more effectively.

Business process-as-a-service

Our integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

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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