Improve plan accuracy and quality

Regulatory compliance

Simplifying a complex regulatory environment

Cognizant helps healthcare organizations evaluate the impact of regulatory requirements and implement solutions that help ensure compliance. Our services include:

• ICD-10
• Medicare Part D compliance
• NCPDP D.0 compliance
• Controlled substance dispensing
• Patient compliance

Health intelligence and analytics

Driving better health outcomes

The ability to access and leverage data is changing the way business decisions are made, with rich insights enabling evidence-based decision-making and proactive planning. Cognizant provides expertise on data collection across a wide range of attributes affecting pharmacy and PBM businesses, helping them make well-informed decisions in:

• Analytics strategy
• Process innovations

Investigative services

From detection to prevention

Enabling organizations to identify and resolve intentional and unintentional errors or verify the absence of both is critical. With significant capital lost to fraud and abuse each year, investigation and recovery efforts are key to an organization’s overall financial health.

Operational improvement

Invest in the digital future

We help healthcare organizations drive cost reduction and revenue enhancement through improved efficiency, effectiveness and process transformation by offering:

• Best-in-class services (claims, enrollment and medical management)
• Requirements definition
• Product evaluation and selection
• Operational readiness

Consumerism

Empower consumers with digital tools

New consumer-focused operating models in healthcare demand a shift in thinking, requiring many companies to go from a B2B to a B2C focus. Cognizant helps healthcare organizations manage the patient and member experience with solutions that drive engagement and help build effective strategies for member identification and retention. Our services span these areas:

• Customer engagement
• Customer experience
• Customer retention

Implementation services

Deliver digital health services at scale

We offer complete project and IT implementation and support services, including:

• Legacy systems modernization
• Administrative, claims management, clinical and electronic health record implementations
• Custom development and maintenance
• Systems integration and program management
• ERP and CRM systems
• Data warehouses
• E-health, self-service applications and portal development