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As specialty plans increase in popularity among individuals and employer groups and as payers expand their portfolios with new offerings, the demand is growing for solutions thatmanage multiple lines of specialty products seamlessly via a single, integrated platform.
These solutions must also be flexible enough to support diverse specialty plan designs. Because each line of business makes its own demands on claims processing, capitation/risk-fund accounting, premium billing, network management and more, customizable functionality is essential to accommodating the different plan nuances.
The Cognizant line of TriZetto Healthcare Products offers technology that combines flexibility with industry-leading innovation to support a wide array of specialty plans administered in combination with core and other specialty plans or on a standalone basis. These solutions can be delivered in the licensed, hosted, business services or combined format, whichever is best for your business model. Manage the following specialties:
Increases payer efficiency, improve productivity, reduce costs and position your business for growth.
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.
Automates pricing scenarios to provide the best value to payers, providers and patients.
Enables payer/provider collaboration to reduce costs and drive overall quality improvement.
Members may interact anytime, anywhere and receive a detailed view of their coverage information with compelling metrics, timely notifications and relevant healthcare content.
This integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.
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.
Manages EDI trading partners with one cost-effective, cloud-enabled technology service.
Connects care managers to members and providers while reducing costs, personalizing interventions and improving care quality.
Automate and simplify operational tasks associated with our core healthcare technology solutions, Facets and QNXT.
Extend the functionality of your core system by providing critical capabilities from enrollment through risk adjustment, to efficiently administer government solutions.
Automates transaction processing and information exchange between payer organizations and their external constituents.