List of Cognizant TriZetto QNXT Customers
Cognizant
300 Frank West Burr Boulevard,
Teaneck, 7666, NJ,
United States
Teaneck, 7666, NJ,
United States
1 201-801-0233
Professional Services
349800
$19.7B
Since 2010, our global team of researchers has been studying Cognizant TriZetto QNXT customers around the world, aggregating massive amounts of data points that form the basis of our forecast assumptions and perhaps the rise and fall of certain vendors and their products on a quarterly basis.
Each quarter our research team identifies companies that have purchased Cognizant TriZetto QNXT for Core Admin Processing System from public (Press Releases, Customer References, Testimonials, Case Studies and Success Stories) and proprietary sources, including the customer size, industry, location, implementation status, partner involvement, LOB Key Stakeholders and related IT decision-makers contact details.
Companies using Cognizant TriZetto QNXT for Core Admin Processing System include: UnitedHealth Group, a United States based Insurance organisation with 400000 employees and revenues of $400.28 billion, CVS Health, a United States based Healthcare organisation with 219000 employees and revenues of $372.81 billion, Cigna Healthcare, a United States based Insurance organisation with 71295 employees and revenues of $244.38 billion, Humana, a United States based Insurance organisation with 65680 employees and revenues of $117.76 billion, Aetna Inc, a United States based Insurance organisation with 50000 employees and revenues of $105.60 billion and many others.
Contact us if you need a completed and verified list of companies using Cognizant TriZetto QNXT, including the breakdown by industry (21 Verticals), Geography (Region, Country, State, City), Company Size (Revenue, Employees, Asset) and related IT Decision Makers, Key Stakeholders, business and technology executives responsible for the software purchases.
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight |
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Advanced Health | Healthcare | 150 | $20M | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2019 | n/a |
In 2019 Advanced Health implemented Cognizant TriZetto QNXT as its Core Admin Processing System to centralize payer administration and claims adjudication workflows. The deployment focused on payer core administration capabilities, positioning Cognizant TriZetto QNXT for claims ingestion, adjudication logic, remittance distribution, and member entitlement controls across the payer organization.
Cognizant TriZetto QNXT was configured to support electronic claim formats including ASCX12 837P and 837I for professional and institutional billing, and to produce standard EDI acknowledgements and remittances such as ASCX12 999, 277, and 835. Functional capabilities implemented included automated claims adjudication rules, coordination of benefits orchestration, appeals tracking, and exception handling for rejected and duplicate submissions, consistent with core claims processing and payer administration workflows.
The implementation integrated with TriZetto Payer Solutions as the clearinghouse hub for provider electronic submissions, reflecting Advanced Health policy that providers transmit via clearinghouses rather than direct EDI. Explicit integration signals in the provider manual were preserved, including the use of payer IDs DOCSO for professional claims and UOCSO for institutional claims, and routed EDI acknowledgements and remittances back through partner clearinghouses to providers.
Operational scope encompassed the Advanced Health Claims Department, provider billing channels, provider relations, and clinical review through the Appeals Committee and Chief Medical Officer for final determinations. Business functions impacted included claims processing, provider billing and resubmission workflows, coordination of benefits, and utilization management, with procedural controls documented such as timely filing windows, resubmission frequency codes, and requirements for medical records on corrected claims.
Governance and workflow changes formalized appeals and expedited review processes, requiring appeal submissions within 45 days to the Appeals Committee for recommendation to the Chief Medical Officer, and providing an expedited hearing pathway with a two working day decision target in urgent clinical scenarios. Claims rejection handling was implemented as an operational rule set, treating 277 rejections as nonappealable notifications that require correction and resubmission through the established clearinghouse flows rather than appearing on an Explanation of Payment or 835 remittance.
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Adventist Health | Healthcare | 28600 | $6.3B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2018 | n/a |
In 2018 Adventist Health implemented Cognizant TriZetto QNXT as its Core Admin Processing System, deploying the Cognizant TriZetto QNXT claims processing capabilities across its health plan claims organization. The deployment was led under the Cognizant product footprint and was focused on operationalizing adjudication and claims administration workflows used by the organization in the Portland, Oregon area and for its Medi-Cal business lines.
Configuration and functional work included claims adjudication setup, appeals handling, provider dispute resolution, and billing and coding compliance updates, explicitly maintaining ICD-10, CPT, and HCPC code mappings. The implementation documented a claims configuration subject matter expert role, and a training program was implemented to transition a core team of eight claims examiners to Cognizant TriZetto QNXT while establishing regular internal audit processes.
Operational coverage encompassed processing Medicare, Medicaid, Medi-Cal, Medicare Advantage and dual Mediconnect plans, with staff responsibilities for adjudicating claims within established timelines, responding to provider appeals and grievances, and preparing month end reports and quarterly audits. The program included collaboration with IPA and health plan stakeholders to align adjudication logic with multiple contracts, letters of authorization and delegated responsibilities, and the health plan maintained responsibility for external Medi-Cal regulatory agency audits on an annual cadence.
Governance changes emphasized configuration-driven issue management and quality controls, with claims examiners performing routine audits on both examiner and system processed claims, preparing educational material from audit findings, and escalating adjudication gaps to configuration teams for remediation. The implementation narrative centers on operationalizing Cognizant TriZetto QNXT as the Core Admin Processing System, embedding audit and appeals workflows into day to day claims operations and formalizing training and governance for sustained claims administration.
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Aetna Inc | Insurance | 50000 | $105.6B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2015 | n/a |
In 2015, Aetna Inc implemented Cognizant TriZetto QNXT as its Core Admin Processing System. Between February 2015 and June 2017, a QNXT configuration training engagement delivered remote instruction to new and existing staff within Aetna's CSRA division, building internal configuration capability for administrative operations.
Training concentrated on Cognizant TriZetto QNXT configuration workflows, emphasizing enrollment setup, claims adjudication rules, member and provider data management, and plan configuration consistent with Core Admin Processing System functional needs. The engagement covered rule engine parameterization, configuration version control, and application of Aetna-specific configuration processes to operationalize administrative business rules.
Operational scope focused on the CSRA division, equipping operations teams, configuration analysts, and business process owners to manage ongoing QNXT configuration and governance tasks. Delivery was remote and oriented toward transferring configuration responsibilities to internal staff, with documentation and configuration standards created to support change control and repeatable configuration processes.
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Insurance | 395 | $70M | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2017 | n/a |
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Insurance | 250 | $85M | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2016 | n/a |
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Insurance | 10000 | $5.0B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2013 | n/a |
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Insurance | 2500 | $1.1B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2018 | n/a |
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Healthcare | 15000 | $2.4B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2017 | n/a |
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Healthcare | 18630 | $9.8B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2018 | n/a |
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Insurance | 950 | $2.7B | United States | Cognizant | Cognizant TriZetto QNXT | Core Admin Processing System | 2021 | n/a |
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Buyer Intent: Companies Evaluating Cognizant TriZetto QNXT
ARTW Buyer Intent uncovers actionable customer signals, identifying software buyers actively evaluating Cognizant TriZetto QNXT. Gain ongoing access to real-time prospects and uncover hidden opportunities. Companies Actively Evaluating Cognizant TriZetto QNXT for Core Admin Processing System include:
- ASAP Internet, a South Africa based Communications organization with 1300 Employees
- Ibm, a United States based Professional Services company with 288300 Employees
- Housing Studio, a United States based Construction and Real Estate organization with 25 Employees
Discover Software Buyers actively Evaluating Enterprise Applications
| Logo | Company | Industry | Employees | Revenue | Country | Evaluated | ||
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FAQ - APPS RUN THE WORLD Cognizant TriZetto QNXT Coverage
Cognizant TriZetto QNXT is a Core Admin Processing System solution from Cognizant.
Companies worldwide use Cognizant TriZetto QNXT, from small firms to large enterprises across 21+ industries.
Organizations such as UnitedHealth Group, CVS Health, Cigna Healthcare, Humana and Aetna Inc are recorded users of
Cognizant TriZetto QNXT for Core Admin Processing System.
Companies using Cognizant TriZetto QNXT are most concentrated in Insurance and Healthcare, with adoption spanning over 21 industries.
Companies using Cognizant TriZetto QNXT are most concentrated in United States, with adoption tracked across 195 countries worldwide. This global distribution highlights the popularity of Cognizant TriZetto QNXT across Americas, EMEA, and APAC.
Companies using Cognizant TriZetto QNXT range from small businesses with 0-100 employees - 1.52%, to mid-sized firms with 101-1,000 employees - 43.94%, large organizations with 1,001-10,000 employees - 25.76%, and global enterprises with 10,000+ employees - 28.79%.
Customers of Cognizant TriZetto QNXT include firms across all revenue levels — from $0-100M, to $101M-$1B, $1B-$10B, and $10B+ global corporations.
Contact APPS RUN THE WORLD to access the full verified Cognizant TriZetto QNXT customer database with detailed Firmographics such as industry, geography, revenue, and employee breakdowns as well as key decision makers in charge of Core Admin Processing System.