The certification validates that ClaimSphere QaaS has passed the testing of its solution and that solution provides payers with a solution to improve quality measures performance and care coordination. NCQA also confirmed the integrity of ClaimSphere QaaS in meeting NCQA standards and that it produces accurate and timely results for the 2018 Healthcare Effectiveness Data and Information Set (HEDIS) reporting season. Cognizant is also a NCQA certified vendor for HEDIS, P4P® and eCQM (electronic Clinical Quality Measures).
“Cognizant is committed to partnering with our customers to drive a collaborative, population-focused approach towards quality management. With TriZetto, we have an unparalleled capability to deliver quality improvement insights on a real-time basis,” said Kaushik Bhaumik, Senior Vice President and Global Leader, Cognizant Healthcare. “The NCQA certification for our ClaimSphere platform further validates our mission to help our customers improve their ratings, meet current regulatory requirements and improve the quality of their services.”
Cognizant’s TriZetto Healthcare Products are software solutions that help organizations enhance revenue growth, drive administrative efficiency, improve cost and quality of care, and enhance member and patient experience. ClaimSphere QaaS is a digital analytics platform for quality measurement and reporting. The platform provides health insurance payers with data-driven insights that deliver better patient care, lower operating costs, and provide greater agility in meeting regulatory and market-driven requirements.
ClaimSphere products drive near real-time care gap analytics at points of care and provide deeper understanding of patient data and charts timely interventions for high quality outcomes. Built on advanced analytical models and with superior drill down capabilities, the platform offers actionable insights on non-compliant members, open gaps in care, provider performance and benchmarks with peers. Health plan managers have access to measures and member level details, metrics, rates and comparisons in real-time to proactively identify areas of improvement.