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Benefits administration has expanded to encompass a diverse array of initiatives. The TriZetto Premier Partnership Program was established to provide TPAs with integrated, affordable access to innovative products that compliment the QicLink core application and help manage the cost and quality of care.
The premier partners provide solutions that have been pre-integrated with the QicLink platform and optimal vendor pricing has been negotiated. TPAs can now deliver high-performance, high-impact services similar to those in place at larger organizations.

Partners

Benefitfocus

Benefitfocus® solution utilizes healthcare data to manage plan risk and create actionable reporting analytics. Available exclusively to QicLink core application users, this solution populates standard, ad hoc and in-depth reporting tools with QicLink data, allowing the dissemination of monthly reports via single sign-on access to a secure website. Flexible reporting options and the ability to dig deep into a wide array of details provide the insights required to make informed, cost-effective health and wellness decisions.

Cognizant Partner

Change Healthcare

Change Healthcare is an integrated partner product with the QicLink™ enterprise core administration system, providing advanced payment processing technology with a wide range of printed and electronic payment options available through a single platform. These solutions can reduce administrative costs by maximizing adoption of electronic payments, and reduce print and mail costs for print-related payments by consolidating printing and correspondence. Participation in the Change Healthcare HealthPayers USA Postage cooperative—the nation’s first and largest healthcare postage co-op—offers significant postage and operational savings. Full-color printed or electronic EOBs, omni-channel communications, and monthly or episodic consolidation options help to reduce administrative costs and differentiate your consumer experience. Preference-based intelligent payment analytics can determine the most cost-effective payment distribution channel.

Cognizant Partner

 Cigna Healthcare℠

Through our relationship with Cigna Healthcare SM, we offer access to The Cigna Healthcare National Medical and Dental PPO Networks1. Participation in this program provides access from a trusted brand to nearly 1.2 million2 healthcare providers, 6,200 hospitals2 and 130,586 dentists at more than 284,360 locations3. This means expanded network access for employer groups, as well as discounts that help drive increased plan savings, with the average in-network medical discount being 58.6%4. This robust and competitive healthcare professional/dental network offering is delivered via personalized administration services using the QicLink core administration system.

Cigna Healthcare is an independent company and not affiliated with Cognizant. Access to the Cigna Healthcare PPO network and the Cigna Dental PPO Network is available through Cigna Healthcare's contractual relationship with Cognizant. All Cigna Healthcare products are provided exclusively by or through operating subsidiaries of Cigna Healthcare, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo and other marks are owned by Cigna Intellectual Property, Inc.

1The Cigna Healthcare PPO Network refers to the healthcare providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.

2Cigna Healthcare analysis of actual providers contracted as part of the Cigna Healthcare PPO Network for Shared Administration as of July 2023. Data is subject to change.

3Cigna Healthcare analysis as of 3/31/23. Data is subject to change. Contracted access point accounts for every provider at every contracted location; provider may practice at more than one location so may be counted more than once.

4Average discount based on actual Cigna HealthcareSM PPO Network paid claims for the period 1/1/22–12/31/22. Cigna Healthcare analysis conducted July 2023. Actual results may vary based on utilization, plan design, and geography.

Cognizant Partner

ECHO®

ECHO® is an insurance technology company focused on removing the complexity and costs of healthcare payment processing. We manage every aspect of the payment process through a single HITRUST-certified platform fully integrated with TriZetto QicLink: claim disbursement, provider EFT and ERA enrollment, compliance, reconciliation, reporting, and 1099 processing. With this simplified approach, we save our customers over $1 billion annually while issuing over 500 million transactions totaling over $100 billion in Payments. ECHO maintains the largest network of healthcare provider payment and remittance delivery preferences and prides itself on providing the most electronic options to providers in a secure environment. The variety of our payment modalities promotes the most significant level of electronic adoption. At the same time, our fraud prevention tools comfort the over 330 payer customers and over 1 million providers in our network. QicLink clients can eliminate 100% of print and postage expenses while achieving industry-leading electronic settlement rates.

Cognizant Partner

Zelis® Payment Integrity

The Zelis Payment Integrity Claims Editing solution uses leading-edge technology combined with expert insight to analyze claims and identify billing and coding accuracy by cross-referencing claims history and claims data. Their fast, accurate results are fully aligned with industry-recognized guidelines, ever-changing compliance requirements and a client’s unique needs. All of this is completed before any payments are made. The Zelis Payment Integrity Claims Editing solution is tightly integrated with QicLink via the ClaimsExchange Post-Adjudication Processing functionality.

Cognizant Partner

Zelis™ Payments is integrated with QicLink to streamline the transfer of healthcare payments and data. Operational expenses are reduced because Zelis Payments manages the provider recruitment and enrollment process, while print costs and postage expenses are decreased through virtual credit card/electronic payments. Administrators receive detailed reports of electronic payments issued, and have 24/7 access to information via a secure payer web portal.

Cognizant Partner

Zelis RedCard

RedCard  (Zelis Payments Optimization) offers QicLink integrated healthcare claims communication and ID card fulfillment services. This integration allows QicLink clients to quickly and easily produce claims payment, Explanation Of Benefits (EOB) and pended claims communications data output for transmission to RedCard for payment and communications fulfillment. Customer service representatives, members and providers are able to view images of checks/EOBs via the web browser-based QicLink Customer Service and QicLink Benefits Exchange solutions.

Cognizant Partner

QicLink modular add-ons

QicLink Business Extension

Optimize operations and extend application functionality

QicLink Specialty Modules

Comprehensive functionality to support specialty lines of business

QicLink Network & Care

Effective tools that support today’s complex provider network and care management initiatives

QicLink Partners

Manage the cost and quality of care with access to affordable, QicLink-integrated solutions

ClaimsExchange

Connect to a vast network of PPOs for electronic claims routing and re-pricing

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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