Cognizant Government Solutions

Our Medicare and Medicaid solutions include market-leading software coupled with infrastructure, advisory, and business process services needed for plans to compete and succeed in these highly regulated health plan environments.

Learn more about All of our Payer Services

Cognizant Government Solutions

Our Medicare and Medicaid solutions include market-leading software coupled with infrastructure, advisory, and business process services needed for plans to compete and succeed in these highly regulated health plan environments.

Learn more

about All of our Payer Services

Cognizant/TMG Health BPaaS Solutions

Business Process-as-a-Service (BPaaS) solutions allow you to focus on core business opportunities and free up capital to invest in innovation. Our government programs BPaaS brings together automation, expert insight, best-in-class industry processes and platforms, and an outcome-driven, integrated service delivery and program governance framework.

Managing your government programs with our BPaaS solution provides you the ability to leverage best-in-class technology built on standard configurations without major capital outlays. That technology, combined with our team of government programs subject matter experts, can support end-to-end capabilities across your business and address the pressures of both Medical Loss Ratio (MLR) and Administrative Loss Ratio (ALR), enabling you to focus on:

Creating new products

Cultivating a better customer experience

Establishing a strong, competitive differentiation

Business Process-as-a-Service (BPaaS) for Medicare Advantage, Medicare Part D & Managed Medicaid

  • Claims Management
  • Enrollment & Billing
  • Print Fulfillment
  • Member & Provider Call Services
  • Appeals & Grievances
  • CMS & State Reporting
  • Compliance Oversight
  • Audit Management, and more!

Our flexible BPaaS operating infrastructure enables healthcare organizations to reduce administrative costs while improving data quality and patient and provider experiences.

The Case for BPaaS

Healthcare is at a point of convergence – industry shifts are impacting the way healthcare is done today.

While there are many factors contributing to the industry-wide shift, as-a-service models are changing how businesses are investing in technology and providing the necessary operational agility to expand as the market grows.

Given the current political climate, financial pressures and compliance requirements that government health plans are now experiencing, as-a-service models are the way forward.

Industry News… View All

  • News Scroll

    • July 12, 2018 - Healthcare DIVE
      In a survey of 146 U.S. C-suite hospital executives, reducing costs rose to the top of corporate concerns, the Advisory Board Company found. Nearly two-thirds (62%) of respondents said they were concerned about preparing their organization for sustainable cost control, while 56% cited innovative approaches to expense reduction.
    • July 11, 2018 - Mark Farrah Associates
      According to Kaiser state facts, average Medicaid & CHIP enrollment before the Affordable Care Act was enacted was 56.8 Million. As of December 2017, total Medicaid & CHIP enrollment was 74.6 Million. This represents an increase of 17.8 Million, or 31%. Medicaid remains the largest health program in the U.S. As measured by enrollment.
      Medicaid enrollment in Managed Care Organizations (MSOs) continues to rise due to ACA Medicaid expansion and states that have expanded their managed care programs to new regions. Mark Farrah Associates (MFA), reported total U.S. enrollment in managed Medicaid plans increased only slightly as of December 2017.
    • July 5, 2018 - Healthcare Info Security
      Criminals with a penchant for launching online attacks must have thought they had it made when Ransomware came along.....They could just forcibly encrypt many of the files on the victim's PC and demand they pay a ransom in tough-to-trace cryptocurrency.
      So it's notable that while Ransomware attacks haven't gone away, they have been supplanted by malware that's designed to infect systems and use their CPUs to mine for cryptocurrency.
    • July 3, 2018 - Health Leaders Media
      The sale gives Centene a foothold in the Empire State, a prize in the managed care market, and allows the archdiocese to establish a multi-billion dollar health foundation.
    • July 3, 2016 - AHIP
      Medicare Advantage is an option within Medicare that provides the same benefits as traditional Medicare, but includes additional services and coverage like prescription drugs, vision, hearing, dental and wellness care. Today, the program stands strong with more than 20 million Americans enrolled in a Medicare Advantage health care plan.
    • July 12, 2018 - CMS
      CMS proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare.
    • June 7, 2018 - Healthcare Finance
      A new survey from Lumeris found that 27% of major U.S. health system executives intend to launch a Medicare Advantage plan in the next four years. Despite that, confidence among these same execs is lacking, with only 29% reporting they felt confident in their organization's ability to make the launch successfully.
    • June 13, 2018 - Healthcare DIVE
      More than a third of Medicare fee-for-service beneficiaries had supplemental Medigap coverage at the end of 2016, according to a new report from America's Health Insurance Plans.
    • June 13, 2018 - Fierce Healthcare
      Skyrocketing specialty drug costs were a primary reason behind Cigna's decision to purchase Express Scripts, even though the insurer has an in-house pharmacy benefit manager, Cigna's CFO said:
    • June 13, 2018 - Cognizant:
      Cognizant's 2018 ranking marks the 17th consecutive year the company appeared on the list. The company has consistently placed among the 10 top companies featured on the annual HCI 100, which ranks companies by size based on revenues derived from healthcare IT products and services.
TMG Health, Inc.
A Cognizant Company
100 Four Falls Corporate Center – Suite 406
Conshohocken, PA 19428
 1-800-331-4314