Case Study: Geisinger Health Plan improves claims accuracy and automation with Tegria and TriZetto Facets

Automating Claims Payment Improves Efficiency and Accuracy

Geisinger Health Plan, a regional health insurance provider, faced the challenge of upgrading its outdated and inefficient claims payment system. They engaged the vendor Tegria to select and implement a new core claims platform to save time and resources through automation for their Medicare, Medicaid, and commercial lines of business.

Tegria conducted a system analysis and recommended implementing Cognizant’s TriZetto Facets and NetworX Pricer platforms. Tegria converted the customer's database, developed an Operational Data Store, and configured the new systems to automate claims processing. This resulted in an on-time, on-budget implementation that significantly improved claims accuracy, increased auto-adjudication rates, and improved integrations with third-party vendors.

Geisinger Health Plan