TriZetto Risk Adjustment Manager, supported by Cognizant software, provides healthcare plans with an automated approach to risk, data, and revenue management. The solution analyzes claims and pharmacy information to assess member morbidity, estimate risk scores, and project revenue impacts from suspected or confirmed additional hierarchical condition categories. Cognizant software helps identify members and providers with significant revenue-management opportunities, evaluate CMS risk-adjusted payment accuracy, and submit documentation for newly identified diagnoses. It also generates audit-ready reports and supporting records, enabling Medicare Advantage and Part D organizations to improve reimbursement accuracy, strengthen compliance, reduce administrative effort, and better manage membe

Join for free to read