November 28, 2022
RE: New Claims Platform and Third-Party Administrator
Dear Commonwealth Care Alliance Provider:
Commonwealth Care Alliance (CCA) is pleased to announce that Cognizant will replace PCG as the new third-party administrator and will implement the new claims platform Facets, effective Q2 2023, in order to:
- Improve service-level agreement (SLA) turnaround time;
- Enhance the paper and electronic claim submission process; and
- Utilize a single claims system for all CCA product lines offered in Massachusetts and Rhode Island.
Cognizant is an industry leader known for successful implementations, seamless processes, best-in-class claims platforms, and delivery of a quality provider experience.
CCA will implement the Cognizant Facets claim system, Availity® Essentials Provider Portal, and EDI Gateway solution to improve claims adjudication and access to eligibility verification.
We are grateful for your partnership and look forward to achieving strong business results together. CCA is committed to delivering a seamless implementation and providing monthly communications about key dates and activities on the horizon. If you have any questions, please contact CCA at 888-410-0577.
Vice President, Provider Network Strategy