TriZetto Healthcare Products provides an extensive portfolio of capabilities to meet the specific needs of your Medicare Advantage business.
Solutions that grow medicare markets
Our experience and capabilities will help you effectively address your Medicare administration needs, revenue management and data submission so you can respond quickly to evolving mandates and regulatory requirements.
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:
Automatically enroll new members
Generate, edit and reconcile required encounter data submissions
Accurately reconcile Medicare members
Enhance risk score accuracy to receive proper reimbursement
Identify where members have Hierarchical Condition Categories (HCCs)
Utilize analytics to improve your Five-Star Quality Rating
Coordinate and improve care for Medicare members
Manage new reimbursement and care models
Products
Core Administration
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.
Members may interact anytime, anywhere and receive a detailed view of their coverage information with compelling metrics, timely notifications and relevant healthcare content.
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.
Extend the functionality of your core system by providing critical capabilities from enrollment through encounter submissions, to efficiently administer government solutions.
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.