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2025 Best In Klas

Claims & Administration Platforms (Payer)

REAL-TIME DATA

2025 Best In KLAS Claims & Administration Platforms (Payer)

Claims & Administration Platforms (Payer)

Best in KLAS Winner

Overall performance score
(100-point scale)

REAL-TIME DATA

Ranked Solutions
Market average: 80.8
Software average: 80.6

Grading Scale

	Overall performance score (100-point scale)	Trend (2024-2025)	# of unique orgs	Culture	Loyalty	Operations	Product	Relationship	Value

Cognizant TriZetto Core Claims/Administration Solutions	85.7	+13%	17	B-	A	B	B	B+	B

HealthEdge HealthRules Payer	83.3	+7%	12	C+	A	B-	B	B	B-
	0.0	100.0

Cognizant
TriZetto Core Claims/Administration Solutions

85.7

17

culture

B-

loyalty

A

operations

B

product

B

relationship

B+

value

B

HealthEdge
HealthRules Payer

83.3

12

culture

C+

loyalty

A

operations

B-

product

B

relationship

B

value

B-

Additional Performance Insights Additional Performance Insights

Ranked solutions for which at least 95% of respondents answered yes.

Part of long-term plans?

Cognizant
TriZetto Core Claims/Administration Solutions

n=17 100%

HealthEdge
HealthRules Payer

n=12 100%

Would you buy again?

Cognizant
TriZetto Core Claims/Administration Solutions

n=17 100%

Part of Long Term Plans?

Cognizant
TriZetto Core Claims/Administration Solutions

n=17 100%

HealthEdge
HealthRules Payer

n=12 100%

Would you buy again?

Cognizant
TriZetto Core Claims/Administration Solutions

n=17 100%

Solutions Not Ranked

Ordered alphabetically

C L R

	Overall performance score (100-point scale)	# of unique orgs	Culture	Loyalty	Operations	Product	Relationship	Value

Epic Tapestry (Core Admin) C	81.3	14	C+	A-	C	C+	B	B

Mphasis (Eldorado) Eldorado Core Claims Solutions L R	62.2	3	F	D+	C+	D-	—	B

C L R

&nbps;

Epic
Tapestry (Core Admin) C

81.3
14

culture

C+

loyalty

A-

operations

C

product

C+

relationship

B

value

B

Mphasis (Eldorado)
Eldorado Core Claims Solutions L R

62.2
3

culture

F

loyalty

D+

operations

C+

product

D-

relationship

—

value

B

Related Reports

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Emerging Technology

SKYGEN Core Administration Solutions 2023

02 August 23 | Jacob Brown and Joe VanDeGraaff

SKYGEN aims to transform benefits management and administration for specialty payers to reduce costs and increase satisfaction for all involved. Currently focused on dental and vision payers, SKYGEN offers a variety of technology to fill all common core administration needs. All solutions are available as a SaaS platform or through SKYGEN’s third-party administrator (TPA) model. This report examines the SKYGEN customer experience.

Emerging Technology

Viveka Health Benefits Administration Platform 2023

16 June 23 | Jacob Brown and Joe VanDeGraaff

The complexity of benefits administration can draw focus away from improving health and wellness opportunities for health plan participants. Viveka Health’s benefits administration solution aims to help by integrating all functionality required to administer benefits into one comprehensive platform, allowing payers to communicate, manage claims, and analyze data all in one place. This report explores the experiences of six unique Viveka Health customers and their satisfaction with the platform.

Points of Light 2023 Case Study 4

13 April 23 | Aurene Wilford and Boyd Stewart

Claims data from payer organizations can give providers a more comprehensive view of a patient’s clinical history and thereby improve the quality of care they are able to deliver. Yet incorporating this information at the point of care can be expensive and challenging. To tackle this problem, the collaborators in this project worked to map the payer organization’s claims data so that it could be incorporated into provider workflows in real time at the point of care.

Points of Light 2023 Case Study 9

13 April 23 | Aurene Wilford and Boyd Stewart

Submitting and following up on requests for prior authorization is often a manual, time-consuming process, creating administrative burden for both payer and provider organizations and potentially delaying needed care for patients. The stakeholders in this collaboration worked to streamline the process by automating the submission and follow-up for authorization requests, enabling providers to complete these tasks from within their EMR workflow. Results include faster turnaround times, reduced administrative workload, and fewer denials.

Past Claims & Administration Platforms (Payer) Awards