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

    March 26, 2018 - Business Wire:
    Mark Farrah Associates, reported in its latest analysis brief that Medicare Advantage membership exceeded 21 million as of February 1, 2008, compared to 19.6 million a year ago. Managed Medicare continues to be an attractive growth market for health insurance companies as only 34% of the 61 million people eligible for Medicare across the U.S. and U.S. Territories are enrolled in MA plans:
    March 26, 2018 - AHIP
    Last year, Tennessee collected more than 68,000 pounds of pills. The collection was part of Count it! Lock it! Drop it! nonprofit initiative that helps people in 69 counties across the state. It is funded in part by the BCBS of Tennessee Health Foundation:
    March 1, 2018 - HCSC
    HCSC, the nation's largest customer-owned health insurer, today announced it has committed $1.5 Billion over three years to accelerate its efforts to reduce health care costs for its members. The new endeavor, Affordability Cures, builds on the company's efforts to control medical & administrative costs for the long-term and was bolstered by benefits due to the more recent tax cuts & job act.
    March 6, 2018 - KFF.org
    The Henry J. Kaiser Family Foundation (KFF) announced today that it has relocated its headquarters to 185 Berry Street in Downtown San Francisco. KFF's new headquarters in the city's China Basin neighborhood is located just opposite AT&T ballpark at the water, and will feature an event space for KFF events and will be available to other organizations to use free of charge.
    March 8, 2018 - CNBC News
    "The current marketplace is not sustainable, Cigna CEO said on $67 Billion deal for Express Scripts. The market demands more affordability, the market demands more personalization, the market demands more value....we will be well-positioned".
    November 30, 2017 - AHIP:
    Medicare Advantage provider networks offer seniors more options, high value & better benefits. The use of provider networks is an important difference between Medicare Advantage and Traditional Medicare. Thanks to these high-value networks, Medicare Advantage seniors access the care they need & would otherwise not be able to afford:
    January 10, 2018 - Healthcare Finance:
    AHIP, which added 12 new insurer members last year, said it remains a strong advocacy organization for payers & consumers. AHIP said Humana's decision to leave was communicated to them as a business decision, rather than being related to policy according to spokeswoman Kristine Grow:
    November 6, 2017 - AIS Health:
    Blues Plans in many states will continue to offer individual policies on the Affordable Care Act (ACA) exchanges, but high-profile state withdrawls by insurers such as Anthem, Inc., and Wellmark BCBS will limit the overall Blues footprint on the individual market for 2018:
    January 10, 2018 - CMS.gov
    We're removing Social Security numbers to prevent fraud, fight identity theft and keep taxpayer dollars safe.
TMG Health, Inc.
A Cognizant Company
100 Four Falls Corporate Center – Suite 406
Conshohocken, PA 19428
 1-800-331-4314