tmghealth.comTMG Health, A Cognizant Company, Business Process-as-a-Service

Vision & Mission Locations Conshohocken, PA Jessup, PA Amarillo, TX Fact Sheet Awards Industry Associations Solutions Medicare Medicaid Medicare Part D/PDP Resources Collateral Case Studies White Papers Webinars News & Events Industry News Press Releases Events Careers Job Listings Employee Benefits Career & Employment FAQs Internships Inclusive Culture Remote Career Opportunities Job Fairs Contact Us Home About Vision & Mission Locations Conshohocken, PA Jessup, PA Amarillo, TX Fact Sheet Awards Industry Associations Solutions Medicare Medicaid Medicare Part D/PDP Resources Collateral Case Studies White Papers Webinars News & Events Industry News Press Releases Events Careers Job Listings Employee Benefits Career & Employment FAQs Internships Inclusive Culture Remote Career Opportunities Job Fairs Contact Us 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! Perspectives From BPS to BPaaS: Increasing Value and ROI for Healthcare Payers (Part one of a two-part series) Read Now How BPaaS Grows Healthcare Payer Membership, Improves Revenue (Part two of a two-part series) Read Now BPaaS INFOGRAPHIC 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. Medicare Solutions Medicaid Solutions Medicare Part D/PDP Industry News… View All News Scroll Centene CEO: ’The Time Was Right’ to Buy WellCare For $15 Billion: March 27, 2019 - CNBC "What I’ve always found is when there’s a certain amount of uncertainty, there’s a challenging environment, that’s the time to act". Centene CEO Michael Neidorff says about its acquisition of WellCare: What The Future of Cloud Computing Holds For Health Insurance Companies: March 29, 2019 - Healthcare IT News IaaS & SaaS offerings are enabling payers to run analytics against claims and other data in new ways that enable them to operate more efficiently: Medicare, Medicaid Best Private Plans For Containing Health Costs: February 12, 2019 - Health Payer Intelligence Medicare & Medicaid showed slower health spending growth per enrollee than private insurance: CMS Finalizes Policies to Bring TeleHealth Benefits to MA: April 5, 2019 - CMSgov Policy section 50323 allows MA plans to offer ’additional telehealth benefits’ as part pf the government-funded "basic benefits": The Health Insurer With Largest Individual Market Share in Each State: March 25, 2019 - Becker’s Hospital Review In at least 37 of 50 states, plus the District of Columbia, the 3 biggest health insurers held 80% of the individual exchange market from 2015-17, according to a Government Accountability Office analysis: CIGNA Revenue Boosted By Commercial Growth, Now Eyes Medicare Advantage: November 1, 2018 - Healthcare DIVE: Cigna announced Thursday its revenue increased by 9% to $11.5 Billion in the 3rd Q and credited its global healthcare and supplemental benefits segments. Why RAF Scores Are Vital In A Value-Based World: 3 Qs With Dr. Jon Elion: November 1, 2018 - Becker’s ASC Review: ChartWise Medical Systems Founder & Chief Innovation Officer, Dr. Jon Elion, explained the growing importance of Risk Adjustment Factor Scoring in the outpatient space to Becker’s ASC Review: Medicare Advantage Insurers Could Be On The Hook For Billions From Audit Changes: October 31, 2018 - Modern Healthcare: The CMS wants to make a few dramatic changes to the way it audits Medicare Advantage plans for over-payments, which could leave insurers on the hook for billions of dollars: Health Officials Urge Getting Flu Shot to Prevent Illness: September 11, 2018 - InformNY Health Officials said the only way to save yourself from the flu virus is to get a flu shot. They said the high numbers seen last year were due in part because people weren’t getting vaccinated. Learn more about Cognizant Healthcare Solutions Learn more about Cognizant Healthcare Solutions TMG Health, Inc. 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