Simplify Healthcare & Cognizant: Solving Challenges in Claims Platform Data Integration

Streamlining Claims Management Through Data Interoperability
Simplify Healthcare has partnered with Cognizant to bring you a game-changing solution for ingesting and transforming structured and semi-structured data for claims management systems. Our interoperability-driven partnership bridges the gap between provider data and benefit configurations, making them consumable by TriZetto® Facets® and TriZetto® QNXT™ platforms.
This innovative partnership targets key challenges for payers—data accuracy, operational efficiency, and scalability—using advanced automation tools, including Claims1™, Provider1™, Benefits1™, and Cognizant’s TriZetto® Configuration Orchestrator (TCO®).
Explore the Partnership

Why Interoperability Matters for Payers

Structured and semi-structured benefits and provider data from diverse sources often leads to inefficiencies in claims management systems. This partnership addresses:
Provider Demographic Data Integration

Accurate ingestion and automation through Provider1™.

Benefit Plan Data Transformation

Seamless configuration management with Benefits1™.

Accurate Claims Processing

Improved accuracy and speed with Cognizant’s TCO®.

Together, we automate workflows and provide end-to-end integration across TriZetto® Core Claims Platforms, reducing errors and optimizing speed to market.

What Challenges Does the Partnership Solve?

Our partnership solves pressing challenges that payers face daily while offering significant cost savings and efficiency improvements.
Streamlined Automation

Automate processes for moving provider and benefit data into claims systems.

Enhanced Accuracy

Reduce errors in provider configuration and benefit plan updates.

Optimized Operational Efficiency

Process updates faster and eliminate re-keying.

Accelerated Time-to-Market

Extend selling seasons by streamlining data transformation workflows.

Cost Reductions

Simplify resource allocation and use bi-directional integrations to improve ROI.

How Our Integrated Solution Works

Understanding our integration is key to realizing its many benefits. Here’s how Simplify Healthcare and Cognizant’s solution works:
Data Intake

Ingest structured and semi-structured data from benefit plans and external providers using APIs or batch files.

Transformation & Mapping

Utilize reusable mapping rules, checklists, validation processes, and pre-configured templates in Claims1™.

Configuration Transmission

Cognizant’s TCO® accepts and deploys configurations to claims systems—ensuring, corrections, and validation updates.

Results Feedback Loop

Final outcomes are looped back into claims systems for reconciliation and continuous optimization.

Facets® Partnership
QNXT™ Partnership

Why Choose Simplify Healthcare & Cognizant?

This is not just another custom-built integration. Our solution brings unmatched value to payers
Tick A Fully Supported Integration
Unlike custom implementations, our solution offers long-term support through a fixed annual license fee.
Tick Upgradable Product Path
Integrated improvements and expansions aligned with future regulatory requirements.
Tick Accelerated Development
Reusable mappings, templates, and audit workstations.
Tick Streamlined Automation
Transform provider and benefit data into actionable configurations.
Tick Improved Data Accuracy
Automatic loading and translation from source formats.
Tick Cost Reduction and Optimized Resources
Focus on what matters most—your business goals.

Ready to Take Your Claims Management to the Next Level?

Explore Our Solutions and see how the integration of Provider1™, Benefits1™, Claims1™, and TCO® can transform your operations.
Request a Demo Today!

Frequently Asked Questions (FAQs)

What Payers Need to Know Before Elevating Provider Operations with Provider1™

What is TriZetto® Configuration Orchestrator (TCO®)?

TCO® is Cognizant’s automation tool that enables seamless configuration of provider and benefit data into TriZetto® Facets® and QNXT™ claims platforms. It offers bi-directional integrations, making data reconciliation effortless.

How does Simplify Healthcare’s solution assist payers?

Simplify Healthcare’s Claims1™, Provider1™, and Benefits1™ work in harmony with Cognizant’s TCO® to automate workflows, eliminate errors, and reduce timeframes for claims system updates.

Why is this partnership unique?

This interoperability-driven solution combines regulatory compliance, automation, and scalability—something custom-built integrations fail to achieve efficiently.