Workflow Agentic Processing lets health plans clear routine pended claims automatically, freeing staff to focus on exceptions that need human judgment

• Workflow Agentic Processing automates eligible routine pended claims across TriZetto Facets® and QNXT™
• Capability supports governed workflow automation with visibility, auditability and human oversight
• Available for TriZetto Facets and QNXT core administration platforms

TEANECK, N.J., September 28, 2026 -- Cognizant (NASDAQ: CTSH) today announced the general availability of Workflow Agentic Processing and Enterprise Model Context Protocol (MCP) Servers for the TriZetto Facets® and QNXT™ core administration platforms. The Workflow Agentic Processing capability lets AI agents carry out a health plan's standard operating procedures to automate processing of eligible routine pended claims, while denials, exceptions and complex cases are routed to human reviewers when additional judgment is needed. With the accompanying library of 100+ MCP tools, a health plan’s own AI initiatives can be expanded using TriZetto data context to streamline day to day business operations.

Pended claims often require manual review before they can be finalized, adding administrative burden and delaying processing. It's the kind of manual work that automation is increasingly taking on across the industry. The 2025 CAQH Index found that U.S. healthcare avoided an estimated $258 billion in administrative costs in 2024 through electronic transactions and improved data exchange. Workflow Agentic Processing helps health plans reduce manual effort, improve workflow efficiency and manage human and AI-assisted work side by side.

Improving member and provider satisfaction is a daily business necessity for health plans. Servicing members and providers requires ready access to information for responding to inquiries. TriZetto’s MCP tools are expected to help streamline member and provider interactions across a broad spectrum of capabilities from allowing a health plan’s own AI agents to access and summarize data in the TriZetto Facets and QNXT platforms for customer service agents to helping reduce turnaround times for prior authorizations.

The release marks the latest milestone in Cognizant's AI strategy for the TriZetto portfolio, following the TriZetto® AI Gateway and the expansion of agent-ready capabilities through TriZetto Unify.

"Health plans are looking for practical ways to apply AI within the systems that support their most critical operations," said Prasad Sankaran, President,  AI Platforms at Cognizant. "Workflow Agentic Processing helps automate eligible routine claims work, improves operational efficiency and allows organizations to scale AI adoption while maintaining governance and human oversight."

Built into the Facets and QNXT workflow experience, Workflow Agentic Processing uses a health plan's own operating procedures to guide AI-assisted execution. As policies change, organizations can update those procedures to adjust automation without extensive custom development. Work queues, agent actions and outcomes stay visible within the workflow environment, giving teams a clear view of AI-assisted and human activity.

“Workflow Agentic Processing brings intelligent agents directly into the workflows health plans already use every day," said Sanjay Subramanian, SVP and Head of Healthcare Payer Business at Cognizant. "That's the kind of AI-led value payers need right now — fewer pended claims, faster provider payments and full visibility into what the AI touched versus what the human reviewed. With clear guardrails, auditability and human oversight built into the workflow, we help clients move from AI pilots to putting AI to work securely, safely and at scale.”

Early-adopter health plans are currently piloting Workflow Agentic Processing in their Facets and QNXT environments, with performance results to be shared in a future update.

With Workflow Agentic Processing, health plans can:

• Clear eligible routine pended claims automatically
• Speed up workflow throughput, helping providers get paid sooner and patients get care sooner
• Route exceptions and complex cases to human reviewers
• Track AI and human work side by side, in one place
• Update automation by adjusting procedures, not code
• Connect to existing tools, APIs and decisioning systems

TriZetto platforms support more than 200 million healthcare members in the U.S. and process more than $500 billion in annual healthcare spend across claims, eligibility, prior authorization and payment integrity workflows.

Workflow Agentic Processing is available now for clients using the TriZetto Facets and QNXT platforms.

About Cognizant
Cognizant (Nasdaq: CTSH) is an AI Builder and technology services provider, bridging the gap between AI investment and enterprise value by building full-stack AI solutions for our clients. Our deep industry, process and engineering expertise enables us to build an organization's unique context into technology systems that amplify human potential, drive tangible outcomes and keep global enterprises ahead in a fast-changing world. See how at www.cognizant.ai or @cognizant. 

For more information, contact:
Name: Natalie Steffen
Email: natalie.steffen@cognizant.com