TriZetto (Cognizant)
Digital solutions for healthcare.
Overview
TriZetto, a Cognizant company, provides core administrative platforms for healthcare payers, such as QNXT and Facets. These systems manage end-to-end payer operations, including member enrollment, claims processing, and utilization management (which includes prior authorization). The QNXT platform, for example, has a Utilization Management Workflow module to automate and manage the inventory of UM documents and referral requests.
✨ Key Features
- Core Administrative Processing (QNXT, Facets)
- Utilization Management
- Claims Processing
- Member Enrollment and Billing
- Provider Network Management
🎯 Key Differentiators
- Comprehensive, end-to-end payer administration platforms
- Long-standing market presence and large customer base
- Highly configurable and scalable systems
Unique Value: Provides health plans with a robust, scalable, and comprehensive platform to manage all core administrative functions, from enrollment to claims payment.
🎯 Use Cases (3)
✅ Best For
- Used by hundreds of health plans to manage their core operations.
💡 Check With Vendor
Verify these considerations match your specific requirements:
- Healthcare providers looking for a tool to submit authorizations
🏆 Alternatives
Offers a complete, integrated payer platform, as opposed to standalone tools that only address one piece of the puzzle like prior authorization.
💻 Platforms
🔌 Integrations
🛟 Support Options
- ✓ Email Support
- ✓ Phone Support
- ✓ Dedicated Support (Enterprise tier)
🔒 Compliance & Security
💰 Pricing
Free tier: N/A
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