TriZetto: Software Solved

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TriZetto turns data into actionable information for better outcomes throughout the healthcare ecosystem

When it comes to medical care, whether you’re a provider or a patient, you want things to run smoothly. Extra layers of complication are just about the last thing you want. On the technology side of the equation, Cognizant’s TriZetto Healthcare Products Group is often the team behind the scenes providing that easy button.

TriZetto’s software platforms administer healthcare for more than 60% of Americans, and they do it well. If you’re a provider, payer, third-party administrator, or pharmacy benefit manager, you’ve probably used one of the more than 25 major software products. In this “evolve or be left behind” digital revolution, they’re only making things easier, with a multi-year roadmap for continuously innovating their product and services portfolio. As ever, people will be the focus and the driver of their strategy.

Data on Demand

The great need these days is on-demand data access. To offer a scalable and nimble SaaS delivery model, TriZetto is expanding the capabilities of existing products and launching new solutions. The TriZetto Digital Platform that ensures data-driven access and engagement is based on three core tenets: data liquidity, cost and operational efficiencies, and digital engagement. Together they harness the power of data that is spread throughout the healthcare ecosystem, streamlining and gaining insights from it to speed up what has traditionally been a slow and arduous process.

“The platform runs secure SaaS operations on an architecture that offers two significant benefits to our clients: developing and delivering new product capabilities and innovations more quickly and efficiently, maximizing return on investment; and reducing the burden of risk a healthcare organization typically assumes when deploying new technologies,” TriZetto CIO Robert Wise told BOSS. “We maintain and update the software and hardware so our clients can focus on managing the business at hand, not the technology.”

Using Microsoft Azure, TriZetto has built a system-agnostic platform that communicates automatically in real time core administration systems and other critical applications. The end result is that a health plan’s members, providers, and consumers have access to actionable information when and where they need it.

Right Tools for the Job

Better, faster information empowers engagement and improves health outcomes. Synthesizing it all is the task of several key products on the Digital Platform. The Cognizant TriZetto Connected Interoperability Solution gives members secure access to health data from a variety of sources. For patients, EngageMember provides secure access to claims, coverage, cost, and network data in real time. EngageProvider taps into core administrative systems to offer a single source of real-time data, including eligibility and claims status. They and other TriZetto products can ingest data in HL7 V2/3, C-CDA, and 5010 formats.

TriZetto® Touchless Authorization Processing (TTAP) is a real-time cloud-based prior authorization processing SaaS solution for payers and their providers, supporting medical pre-planned inpatient and outpatient procedures. TTAP streamlines the prior authorization process, automates eligibility checks, and identifies whether authorizations or referrals are needed, then provides an immediate automated response. TTAP enables payers to fully automate the authorization of medical services with the creation of both business and clinical rules and can integrate with virtually any health plan.

Ultimately, technology is a tool. Without a purpose-driven team in place, there’s a gulf between data collection and happy, healthy patients.

“You can have the best technology, vision, and strategy, however if you don’t have the right people in place with the right attitude — with everyone all-in — you will not be successful,” Wise said. “This is a focus area of mine and my leaders — being certain we’ve got the right people that want to be a part of something. We all know that technology is useful, powerful, and it’s a means to an end. If you cultivate the proper culture and combine that with technology, you will see amazing results.”

Safe & Secure

Handling so much sensitive data, TriZetto makes cybersecurity a pillar of the Digital Platform. Governance, risk, and compliance (GRC) principles are key components of every operation, from the initial pitch for a new product and throughout its life cycle.

“We employ multiple layers of checks and balance,” Wise said. “There are a variety of security tools and security companies we partner with to help secure our environments and our clients’ data. That is our No. 1 priority since we’ve been trusted with our clients’ assets. We have all these controls in place so our clients are confident that we can deliver on our security declarations or attestations. In other words, we have a security-first culture to keep data safe. Our teams live and breathe security all day every day. They’re the ones that make the difference.”

Constant Innovation

As technology evolves, TriZetto is constantly evaluating, modifying, and expanding its relationships with expert partners and clients to optimize performance and maximize client ROI. Its annual virtual healthcare conference — this year it’s June 13-16 — is a driver of client success, strong partnerships, and innovation. Another is TriZetto’s culture of diversity and inclusion.

“It allows people to be who they are — come as you are — knowing you will be accepted,” Wise said. “That feeling is contagious. When everybody is singing from the same sheet of music — and you know that, ‘Hey, somebody’s got my back, and I’ve got theirs’ — it allows for creativity to flow.”

It also delivers a seamless user experience for all stakeholders. If only everything else about healthcare were so painless.