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Improve Care, Lower Costs

SIMPLIFY YOUR
DUAL ELIGIBLE POPULATION ADMINISTRATION

Achieve effective management of a dual-eligible
population while simplifying processes, boosting automation
and improving member care.

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.

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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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

Business Process Services

Services that offer meaningful, business outcomes.

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Business Consulting

Unparalleled healthcare business consulting expertise.

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Next-Gen Technologies

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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Services/Benefits Administration

Software, technology, expertise and proven methodologies to help you manage your business more effectively.

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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

GET THE RECOGNITION YOU DESERVE

HEALTHCARE EXCELLENCE AWARDS

Congratulations to finalists and winners: Cognizant honors clients using our technology solutions to build new best practices or discover new ways to address changing business models. Find out this year’s finalists and winners and how the healthcare excellence awards program can get your organization the recognition it deserves.

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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.

We’ll be in touch soon.