Industries

Healthcare

THE THINKERS AND DOERS

Unifying healthcare for all

Only Cognizant has the ability to integrate the right technology, services and expertise to create a more unified healthcare experience. For more than three decades, we’ve been the thinkers and doers helping transform America’s biggest healthcare organizations. Today, we’re enabling payers and providers to operate even more efficiently and effectively with digital solutions, so they can achieve better outcomes.

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<h3>The healthcare segments we serve</h3>

Payer solutions

We connect payers and providers to create a frictionless member experience and enable more affordable care.

Provider solutions

Our technology and expertise help providers run their businesses more efficiently and create seamless patient experiences.

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TriZetto Unify: For the moments that matter

TriZetto® Unify is a groundbreaking strategy and framework set to transform payer-provider interactions by enhancing transparency, reducing administrative burdens and helping to improve patient care.

With TriZetto Unify, communication becomes faster and is enriched with comprehensive clinical data to ensure positive “moments that matter” when vital care decisions are supported with the best information available.

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Overview

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<h3>Why Cognizant?</h3>

<p>Cognizant has unparalleled expertise in enabling payers and providers to keep pace with advancing technology, constantly changing regulations and increasing financial pressures.</p> <p>We are 80,000 thinkers and doers who have the right technology, services, expertise and scale to help unify healthcare and achieve better outcomes for all.</p> <p>Cognizant manages 4.4 billion transactions between payers and providers annually, and we’re deeply embedded in 350 major healthcare systems.</p> <p>We’re committed to leading the industry in innovation with a $1 billion investment in gen AI.</p>

4.4 billion

annual payer-provider transactions

350+

major healthcare systems

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80,000+

healthcare industry experts

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Why Cognizant

How we transform organizations like yours

Reduce administrative costs
Drive efficiency in claims processing
Enhance revenue cycle management
Improve the patient experience

Challenge

Improve claims processing speed and accuracy during growing demand for health services in a manner consistent with the broad data compliance and security requirements of Signature Performance serving a government customer.

Success highlights

Achieved a claims auto-adjudication level of 94%, an increase of more than 30%
Achieved an accuracy rate of 98% for claims processing
Auto-adjudicated over seven million claims in the first year of operation
Addressed the government client’s compliance requirements with deployment of the Trizetto® Facets® core administration platform in the Microsoft Azure ^™ Government cloud

Read the full case study

Challenge

Improve automation for El Paso Health to handle growing claims volumes.

Success highlights

Increased market share to 17% through efficient processes
Increased claims auto-adjudication rate by 8.7%
Increased provider satisfaction scores by nearly 15% with utilization and quality management and 20% with network/coordination of care
Achieved 100% automation on reimbursements for complex diagnosis-related group (DRG) contracts
Achieved 100% automation of appeals and grievances as well as full compliance with Texas Medicaid regulatory guidelines

Read the full case study

Challenge

Reduce denied health insurance claims and improve collections for MetroHealth.

Success highlights

Decreased denials by 30%, translating to $13M in additional revenue over one year
Increased average daily collections by 25%

Read the full case study

Challenge

Improve front-end patient access by focusing on up-front payments and prior authorizations for a large US-based health system.

Success highlights

Significant increases in up-front patient collections, accelerating over time:

49% increase in up-front collections in the first six months
304% increase in up-front collections in the first year

Read the full case study

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Case studies

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<h3>Our partner ecosystem enables tailored solutions</h3>

<p>We leverage the 4,850+ product experts in our partner ecosystem to identify and develop the best solutions for your needs, whichever segment you work in.</p>

<p>Please visit our Cognizant partners page to <a href="/content/cognizant-dot-com/us/en/about-cognizant/partners.html" target="_self">learn more</a>.</p>

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Partners

<h3>Consistently recognized by top industry analysts</h3>

<p>Cognizant continues to be recognized in the IT and healthcare markets by the top healthcare industry analysts.</p>

<p>Please visit our Cognizant awards page to <a href="/content/cognizant-dot-com/us/en/orphan/industry-analyst-recognition.html" target="_self" rel="noopener noreferrer">learn more</a>.</p>

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Awards and recognition

<h3>Latest thinking</h3>

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How payers can get a jump on prior authorization changes

Payers can improve member experiences and streamline compliance by leaning into FHIR® standards and investing now in integration with key providers.

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Think “ecosystem” over “enterprise”—healthcare in the age of patient centricity

Health sciences organizations need to recognize key opportunities and areas of synergy to thrive in a more collaborative and value-based health sciences ecosystem.

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Eight steps to improve health equity

Healthcare organizations can make meaningful progress and build healthier businesses by focusing on access to care.

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Health insurers face the billion-dollar AI question

Payers could claim a healthy share of the $1 trillion-plus we expect generative AI to add to the economy—if they widen their focus beyond cost cutting.

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See all

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Thought leadership

<h3>Leadership</h3>

Patricia Hunter-Dennehy

Senior Vice President, Head of Provider/Payvider Business

Sanjay Subramanian

Senior Vice President and Head of Healthcare Payer Business

Craig Mengert

Chief Excecutive, Cognizant TriZetto Healthcare Products

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Leadership

Take the first step

Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital healthcare solutions is vast and growing. Our expertise in healthcare IT services enables us to integrate cutting-edge technology seamlessly into your operations.

Let’s talk about how digital healthcare IT solutions can work for your business.

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