TriZetto Healthcare RCM is Cognizant’s web-based revenue cycle management offering for hospitals, health systems, and ambulatory care organizations. It covers patient access, eligibility and enrollment, coding, clearinghouse services, accounts receivable, and denials management. Patient access tools address staffing shortages, front-end interactions, and financial clearance. Eligibility services include screenings, financial counseling, and application support for Medicaid, Medicare, and charity programs. Clearinghouse capabilities include claim submission and tracking, status inquiries, remittance conversion to EDI 835 files, and payment-process support. Denials technology identifies potential professional and institutional denials, supports appeals and payer follow-up, and provides analytics. Revenue Cycle Management Workflow prioritizes accounts by payer, amount, and age, while ARM Pro identifies common rejection causes. Cognizant reports 650+ electronic medical record integrations, more than 8,000 payer connections, and over 30 years of RCM experience. Pricing is on request.
Who it is for
TriZetto Healthcare RCM is intended for hospitals, health systems, and ambulatory care organizations managing complex revenue cycles. It suits providers needing eligibility, claims, payment, and denials workflows.
What is good
- End-to-end revenue cycle coverage
- More than 8,000 payer connections
- 650+ electronic medical record integrations
- Eligibility verification and enrollment support
- Denials management with analytics
What to know first
- Pricing is available only on request
- Listed provider types focus on healthcare organizations
- Web platform only
Verdict
TriZetto Healthcare RCM covers front-end access through claims, payments, and denials. Its integrations, payer connections, and compliance credentials support large healthcare revenue-cycle operations.
TriZetto Healthcare RCM plans and pricing
All plansCompared on medical billing software
- Eligibility verification
- Yes
- Denial management
- Yes
- Patient payments
- Yes
