TriZetto Healthcare RCM is Cognizant’s web based revenue cycle management offering for hospitals, health systems and ambulatory care organizations. It combines services and software across patient access, eligibility and enrollment, coding, claims clearinghouse operations, accounts receivable and denials management. Patient access services use technology to address staffing needs, simplify front end interactions and support patient financial clearance. Eligibility and enrollment work includes screenings, financial counseling and application support for Medicaid, Medicare and charity programs. The clearinghouse supports claim submission and tracking, status inquiries, remittance conversion to EDI 835 files and claim status inquiries. Cognizant says it has more than 8,000 payer connections, partnerships with over 650 practice management vendors and more than 650 electronic medical record integrations. Denials tools identify potential professional and institutional denials and support appeals, payer follow up and analytics. Revenue Cycle Management Workflow ranks accounts using payer, amount and age, while TriZetto ARM Pro automates identification of common rejection causes. Cognizant reports over 30 years of RCM experience, processing 2.6 billion transactions annually and supporting more than 200 million lives. Its clearinghouse is described as SOC 2 compliant and HITRUST and EHNAC accredited.
Who it is for
TriZetto Healthcare RCM is aimed at hospitals, health systems and ambulatory care organizations managing patient access, claims and denials. It may suit providers seeking a combined set of revenue cycle services and products, including eligibility verification, patient payments and clearinghouse functions.
What is good
- Covers patient access, eligibility, coding, claims, accounts receivable and denials.
- Clearinghouse supports claims tracking and remittance conversion to EDI 835 files.
- More than 8,000 payer connections are reported.
- Cognizant reports 650+ electronic medical record integrations.
- Includes dashboards, issue identification and comparative benchmarking.
What to know first
- Pricing is available on request.
- Listed provider types are hospitals, health systems and ambulatory care organizations.
Verdict
Providers in the listed organization types can consider TriZetto Healthcare RCM for its broad revenue cycle coverage and denials workflow tools. Organizations seeking a published price should look elsewhere or contact Cognizant for pricing details.
Get started with TriZetto Healthcare RCM
- Visit the Cognizant TriZetto Healthcare RCM website.
- Contact Cognizant for pricing details.
- Use the web-based offering.
Limits to know first
Pricing is on request, and the listed provider types are hospitals, health systems and ambulatory care organizations.
Questions about TriZetto Healthcare RCM
How much does TriZetto Healthcare RCM cost?
Pricing is on request; Cognizant directs prospective customers to contact it for details.
Which organizations does it serve?
The listed provider types are hospitals, health systems and ambulatory care organizations.
What revenue cycle functions does it cover?
Coverage includes patient access, eligibility and enrollment, coding, clearinghouse services, accounts receivable and denials management.
Does it support eligibility verification and denial management?
Yes. Eligibility verification and denial management are listed, and the denials tools support identifying potential denials and streamlining appeals and payer follow up.
What integrations and payer connections are reported?
Cognizant reports more than 650 electronic medical record integrations and more than 8,000 payer connections.
What security credentials are described?
Cognizant describes its clearinghouse as SOC 2 compliant and HITRUST and EHNAC accredited.
TriZetto Healthcare RCM plans and pricing
All plansCompared on medical billing software
- Eligibility verification
- Yes
- Denial management
- Yes
- Patient payments
- Yes
