Faster Decisions, Faster Care: Cognizant Opens TriZetto Unify to AI Agents for Prior Authorization

Cognizant is tackling a significant bottleneck in the U.S. healthcare system by enabling AI agents to manage electronic prior authorization processes within its TriZetto Unify platform. This strategic initiative responds to growing pressure on healthcare payers and providers to reduce administrative overhead without compromising the quality of clinical judgment. The company's approach involves a new headless API model that allows AI agents to interact with TriZetto Unify as primary users, a departure from traditional system integrations. The integration is designed to comply with evolving regulatory requirements, such as the CMS Interoperability and Prior Authorization Final Rule, which mandates payer compliance starting in 2026 and API mandates by 2027. By automating prior authorization, Cognizant aims to significantly cut down the time physicians and their staff spend on these requests, which currently averages 13 hours per week according to the American Medical Association. This administrative burden often delays patient access to necessary care. Prasad Sankaran, President of Cognizant AI Products and Platforms, emphasized that this is a foundational step in opening their healthcare platforms to a new class of enterprise user—AI agents. He highlighted the necessity for such platforms in regulated industries to be policy-governed, auditable, and built on industry-standard healthcare interoperability protocols. Every future solution on the TriZetto Unify platform will inherently treat agents as first-tier consumers, ensuring that as AI agents become more prevalent in enterprise workflows, they operate within a secure and compliant framework, keeping clinical decisions firmly in human hands.