TriZetto Provider Solutions

08/07/2025

CMS projects a 5.06% increase in MA payments under the new HCC model. But without the right documentation, CDI strategy and provider engagement, your organization could miss out.

This webinar will show you:

- What’s changing in HCC categories
- How to optimize RAF scores
- What success metrics and compliance look like under V28

Register here: https://cgnz.at/6187s3zM3

08/05/2025

Chello understands the challenges of managing cash flow with growing uncertainties around claims payments and increasing operational costs. Their innovative platform offers quick, reliable access to funding and insightful financial tools to keep your practice thriving. Get started now: https://cgnz.at/6183szxjz

07/11/2025

Is your credentialing process slowing down reimbursements or risking compliance?

In our upcoming Solution Showcase, we’ll demonstrate how our Credentialing Services help you avoid costly gaps in coverage and accelerate time to revenue by:

🔹 Preventing payment delays
🔹 Eliminating credentialing bottlenecks
🔹 Gaining full visibility into provider status

Join us to see how our proven solution helps you stay ahead of credentialing challenges: https://cgnz.at/6186S7shp

07/10/2025

"Teamship" is a shift from hierarchical leadership to peer-to-peer collaboration in healthcare. It emphasizes co-elevation, psychological safety and shared accountability as essential to improving outcomes and reducing burnout in the healthcare workplace. Organizations that adopt teamship report a 79% increase in candor and a 46% boost in collaboration.

Learn more in the full article: https://cgnz.at/6189S7Xul

As healthcare faces stark challenges, our choice becomes clear: continue with traditional hierarchical leadership that no longer serves our needs or embrace teamship.

07/08/2025

In 2025, the line between physical and mental health is no longer just blurred, it’s obsolete.

At a time when burnout, anxiety and chronic stress are at all-time highs, healthcare providers must evolve to begin integrating behavioral health into primary care.

Integration is about:

🩹 Data interoperability that connects mental and physical health records
🩹 Cross-functional teams trained to recognize and respond to behavioral health needs
🩹 Digital tools that empower patients to proactively manage their mental wellness

The future of healthcare is whole-person care, and we're there.

How is your organization bridging the gap between mental and physical health?

07/02/2025

“Technology can proactively flag potential errors before claims are processed, providing users with comprehensive information to handle claims accurately the first time. This preventative approach significantly reduces rework and revenue leakage.”

Read more about how Cheryl Taylor, Vice President of RCM Advisory at Cognizant, feels will enable organizations to make the shift from reacting to claim denials to proactively preventing them.

https://cgnz.at/6188S2clu

06/30/2025

Healthcare is in a pivotal moment. A recent study reveals how consumer preferences are evolving. AI is welcome, but trust is everything.

Top Insights:
💡 Older adults seeking clarity on care options are most open to in the "Learn" phase
💡 Younger consumers (18-25-year olds) prefer human interaction, especially in the "Buy" phase
💡 AI helps manage ongoing care in the "Use" phase and interest rebounds

These insights indicate that should tailor their AI strategies by age group and journey stage, use transparency and oversight to build trust in diagnostics and use AI to reduce administrative friction, not to replace human care.

The future of healthcare isn't just digital, it's intelligently human.

Read the research: https://cgnz.at/6187SFzwL

06/27/2025

Looking for ways to improve your denials processes?

Check out our Denials Central resource page for 5 steps you can start taking today!: https://cgnz.at/6181SLcgS

Looking for resources to manage your denials management processes? Streamlining saves time & stress -- while increasing your bottom line. Discover the latest resources to help you avoid the rising trend in denials and ultimately bring in more money for your business.

06/26/2025

"Successful approaches emphasize embedding care within local communities and creating other opportunities for collaboration among providers, community organizations and government agencies."

At the J.P. Morgan healthcare summit on innovation, collaboration, value-based care and data interoperability, the complexity of how to navigate Medicaid was a hot topic.

Hear about four major trends in the : https://cgnz.at/6180SLEWn

06/25/2025

What if you could predict before they happen?

With TriZetto® Advanced Claim Editing, can reduce potential denials by up to 50% using AI-driven prediction models trained on millions of historical claims.

This isn’t just claim scrubbing—it’s next-level denial prevention:

✅ 30,000+ advanced coding edits
✅ Real-time eligibility checks
✅ Customizable confidence thresholds for claim suspension
✅ $750K in savings per 100,000 denied claims

Cleaner claims mean faster payments, fewer appeals and more time for patient care.

Learn how to get started today: https://cgnz.at/6184SIkbm

06/19/2025

Cyber threats are becoming increasingly sophisticated. Proposed updates to federal healthcare cybersecurity standards in December 2024 have reignited debate across the industry.

But, as Schell says, cyberattacks are not waiting for legislation.

Learn 4 ways healthcare systems can begin implementing new standards now: https://cgnz.at/6185SvJ4t

Dr. Scott Schell CMO at Cognizant on Healthcare's Cybersecurity Overhaul: Navigating the New Federal Security Standards for Hospitals

06/17/2025

🛎️ Success Story: Reducing Write-Offs with TriZetto Provider Solutions® Eligibility Solution 🛎️

A professional services organization headquartered in the northeastern US faced significant challenges with front-end claim denials.

By implementing the TriZetto Provider Solutions Eligibility solution, it achieved remarkable results:

📉 47% reduction in timely filing denials
📉 14% overall write-off reduction
📉 98% decrease in coordination of benefit inquiries

This transformation streamlined the revenue cycle process and reduced administrative burdens.

Read the full story: https://cgnz.at/6189St0zX