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TriZetto Healthcare Products / Provider Reimbursement Solutions

Proven, fully integrated, provider reimbursement solutions

The NetworX Suite® of provider reimbursement solutions, validated across more than 85 health plans representing over 189 million covered lives, offer the most proven tools to automate provider pricing, modeling and payment bundling. 
Our solutions—NetworX Pricer®, NetworX Modeler® and NetworX Payment Bundling Administration—are fully integrated with each other, and with Facets® and QNXT™ claims systems, which reduces time to value, with lower cost and effort to implement and maintain vs. other vendor offerings.

Products

NetworX Modeler®

Contract modeling application that projects the financial implications of provider contracts, leading to more informed and faster decision-making.

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NetworX Pricer®

Automates claims pricing thereby increasing the speed, accuracy and efficiency of provider contract administration.

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NetworX Payment Bundling Administration

Automates the processing of bundled payments using clinical logic to identify and reprice claims based on their role in an episode of care.

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Lines of business

Commercial

Our comprehensive, flexible and scalable core administrative solutions enable the digital transformation required for success in the commercial market.

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Individual & small group

Support for the economic advantages and efficiencies.

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Specialty

Get flexible IT solutions to address your unique business requirements with customizable functionality.

 

 

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Medicare

Build functionality that adapts to meet the complexities and demands of the Medicare Advantage market.

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Medicaid

Build capabilities that adapt to meet the complexities and demands of the Managed Medicaid market.

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Duals

Apply flexible solutions that streamline the coordination of multiple compliance requirements and ease administration burdens.

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Related services

Business process services

Services that offer meaningful business outcomes.

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Business consulting

Benefit from our unparalleled healthcare business consulting expertise.

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Next-gen technologies

Put next-generation technologies in place that build a stronger, more agile business and lay the groundwork for future AI and automation initiatives.

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Infrastructure services

Get services that ease the strain of managing your infrastructure so you can focus on managing your business.

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IT professional services

Take advantage of our unrivaled resources and healthcare expertise to meet your IT business needs.

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Services/Benefits administration

Apply our proven software, technology, expertise and tested methodologies to manage your business more effectively.

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Business process-as-a-service

Our integrated software and services healthcare BPaaS solution includes process optimization, digitization and large-scale efficiencies.

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Contact us

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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