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QNXT™ Optimization Software Products
To get the most value from QNXT, it must be configured properly, with effective migration capabilities between environments and regions. It is also important to be able to ensure compliance with complex regulatory requirements and manage large changes and volumes of changes quickly. Our suite of optimization solutions gives your IT staff the tools they need to ensure that you will get the best value from QNXT.

With Claim Test Pro, you can test claims data efficiently and cost effectively and verify with confidence that correct claim totals are being paid. The solution greatly reduces the need for manual creation of test cases, automates the management and reconciliation of results, tracks and documents test projects and cases, and electronically converts system data to applicable testing data sets to create a robust and applicable testing environment.

In addition, the Claim Test Pro application provides a comprehensive set of testing suites that provide for more diverse testing schemas, enabling testing of a multitude of provider reimbursement scenarios. The solution automates many processes that previously were done manually, helping plans increase administrative efficiencies by reducing the resources needed to manage these initiatives. An added benefit of the Claim Test Pro solution is that it provides management tools that track and report progress.

Plans that do not have a strategy for testing and validating claims data may be at risk. Claim Test Pro can help you:

  • Reduce overpayments to providers. Data that has been thoroughly vetted helps ensure that your plan is paying its contracted providers the correct amounts.
  • Lower administrative costs. Reducing errors in provider payments reduces manual rework, helping drive down costs.
  • Trim test cycle time. Automation can help you save hundreds of hours building and documenting test cases.
  • Reduce critical defects introduced to production. The application is virtually self-documenting, automatically summarizing what you have tested and reconciled.

Implementing QNXT is an effective way to improve claims processing, group administration, case management and pre-authorizations, to name a few of the many benefits; but ensuring that QNXT continues to satisfy all of your needs and requirements sometimes requires system configuration changes and any changes to be promoted between environments. In some cases, this process can be complicated and time-consuming. The Configuration Solution for QNXT is a combination of tools and services that automate, optimize and help maintain QNXT configurations and promotions. When combined with integration, the solution facilitates a robust configuration data change management process.

Configuration Solution for QNXT allows healthcare organizations to:

  • Track modifications using process-driven automation
  • Compare configuration differences between any environments
  • Migrate configuration changes to any region or environment
  • Ensure adherence to change procedures and approval processes
  • Reduce demands on database administrators during change promotions
  • Perform targeted component migrations of desired configurations
  • Reduce testing demands and rework

Before adding new functions, changing system configurations or design, it is important to test them in a way that keeps health information fully protected. Test Data Generator creates non-production data sets of both transactional and configuration data, allowing healthcare organizations to test possible changes before implementing them. The tool ensures that protected health information (PHI) remains fully secure by stripping the data of personal identifying information and creating key word files with all new identity information. The result is size-controlled data sets of randomized non-production data.

Using Test Data Generator for QNXT, healthcare organizations can:

  • Reduce the risk of exposing PHI that occurs when production data is simply copied into non-production data bases for testing.
  • Create multiple specialized test databases and control their size and composition.
  • Reduce non-targeted environment copies.
  • Decrease demands on specialty IT resources.
  • Improve security.

TriZetto® Testing Automation Suite is a licensed software solution that automates the validation and testing of health plan software product implementations. It can be used to automate data-driven testing such as benefit configuration data, batch processes, API integrations, upgrade and regression testing scenarios and EDI-type transaction processing. Testing Automation Suite can reduce cost and alleviate staffing pressure by automating much of the test execution process.

We offer interfaces with third-party solutions from ECHO, Zelis, and Lyric Secondary Editing that enable quick and seamless data and batch exchanges between these solutions and our QNXT™ core administrative system.

CareAdvance Connect allows care managers to download patient data from their case list in Clinical CareAdvance and conduct offline patient assessments in patient homes. When they have secure Internet connectivity, care managers can upload the completed assessments to Clinical CareAdvance with a touch of a button. 

This seamless data exchange between CareAdvance Connect and Clinical CareAdvance delivers your organization such benefits as:

  • Reduced administrative inefficiencies through accurate, comprehensive data collection
  • Improved care manager productivity and enhanced data integrity
  • Decreased data risk with protected PHI
  • Affordable initial and long-term cost of ownership

Testing teams need a way to quickly analyze if data can be leveraged for test cases and understand coverage gaps. Configuration Data Analyzer analyzes a specific subset of configuration data. This optimization product provides use cases and relevant data models that can be converted into members, providers and claims that are useful for targeted testing. It also delivers relevant statistical models to evaluate risk against volume of testing.

EDI Transactions generator is a web application that provides a faster, smarter, and more effective solution to automate EDI test data creation for healthcare transactions. This solution reduces time-consuming EDI data generation effort by up to 70–80% and produces compliant 834, 837, and other file formats.

Synthetic Executable Enterprise Data is a healthcare test data management tool that provides PHI-free synthetic member and claim data for testing purposes. This synthetic data covers a wider range of real-world scenarios, business processes, and conditions to enable more accurate testing and wider coverage.

Advanced Batch Framework allows clients to quickly build and standardize batch processes and gain more control over batch operations. The flexible solution can support Facets batches in either a traditional data center or cloud-based infrastructures. 

With Advanced Batch Framework, you can to:

  • Execute batch tasks, including custom tasks, with a single runbook to streamline batch monitoring into one job, instead of several
  • Optimize workflows and enhance regulatory compliance by ensuring batches execute properly during scheduled windows
  • Equip business users with easy access to real-time information about batch status
  • Analyze batch processing performance for continuous improvement

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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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