Cognizant: KHS achieves 20% increase in claims auto-adjudication rate

IT outsourcing company Cognizant today announced that Kern Health Systems (KHS), a managed care health plan serving more than 220,000 members in California, achieved 20 percent increase in claims auto-adjudication rates in the first week of deployment of IT modernization.

The IT deal with Cognizant for transforming the technology infrastructure and operations of KHS.

KHS implemented Cognizant’s TriZetto QNXT Enterprise Core Administration Platform to effectively manage more members, meet changing Medicaid requirements and improve patient and provider experiences. Cognizant said it supplies the TriZetto QNXT software platform to several Medicaid Managed Care Organizations in the U.S.

KHS’s new infrastructure will streamline processes and reduce costs associated with the onboarding of new members, said Cognizant.

In its first week of deployment, the Cognizant platform increased KHS’s claims auto-adjudication rates by 20 percent compared to the company’s legacy system.

Cognizant also enabled KHS to achieve higher operational efficiency through the development and implementation of a new solution to expedite the digitizing of paper-based records, enabling more efficient data exchange and record access.

“In today’s evolving healthcare landscape, it is crucial to have solutions in place that can drive efficiencies and adapt to meet new and future regulations and technological disruptions,” said Richard Pruitt, CIO of Kern Health Systems.

Krish Venkat, president, Healthcare and Life Sciences, Cognizant, said: “By working closely with KHS, we have implemented a scalable, next generation IT infrastructure that is designed to increase productivity, reduce operational costs and ultimately provide a better experience for everyone in the healthcare value chain.”