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The number of people receiving Medicare benefits is projected to rise nearly 60% by 2030. For health plans serving this market, long-term success demands increased system efficiencies to support this rapid growth. Medicare market success also requires tools that enable continued compliance with changes in Medicare reporting rules, complex Centers for Medicare and Medicaid Services (CMS) regulations and the Medical Loss Ratio (MLR) requirement.
With more than 30% of all Medicare Advantage and Part D lives processed on our core systems, the Cognizant line of TriZetto Healthcare Products provides an extensive portfolio of capabilities to meet the specific needs of your business. This comprehensive and highly effective combination of advanced technology and services offerings can help you lower administrative costs, increase speed to market and decrease total cost of ownership. Other capabilities work to:
Increases payer efficiency, improves productivity, reduces costs and positions 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.