Provider Network Partners
Provider network partners
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.
Become a partner
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.
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.