Provider network management partners operate in cooperation with the solutions offered in the TriZetto Healthcare Products NetworX suite of network management products and services. These partner organizations have proven their value by delivering complementary software, services or technology that enhances or expands the functionality and effectiveness of the NetworX line of solutions that support contract analysis, claims pricing and value-based-reimbursement administration. The businesses and solutions identified here meet the quality and integrity standards we have established for our partner organizations—allowing integration and/or facilitated interaction with our proven-effective NetworX technology.
The OPTUM® Prospective Payment Systems (PPS) application, maps, groups and prices facility claims to ensure appropriate reimbursement. OPTUM®’s ECMPro™ application integrates with TriZetto®’s NetworX Suite® solution to manage grouping, pricing, editing and mapping for Federal (DRG, APC, ASC, IRF, SNF, CAH, LTCH, IPF, Physician) Prospective Payment Systems (PPS) and more than 20 state and payer specific PPS. Facility (inpatient and outpatient) and professional Medicare PPS, and a number of Medicaid PPS are integrated with NetworX Pricer® to support auto-adjudicated claims processing. Users can also apply the supported Medicare and/or Medicaid PPS to their commercial business processing. The integrated solutions streamline claims-processing workflows to reduce reimbursement errors and improve payment integrity.GO TO PARTNER SITE
If your organization offers solutions that could potentially enhance those offered within Cognizant’s line of TriZetto Healthcare Products and provide added value or an enhanced experience for our payer clients, CLICK HERE. Our Stragetic Alliances Team will work with you to determine if a potential partnership is appropriate.
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