TriZetto: Healthcare Administration and Revenue Cycle Management
TriZetto helps healthcare providers and payers manage administrative workflows and reimbursement. It is designed for health systems that coordinate care management and claims processing.
At a glance
- Category
- Healthcare
- Best for
- Hospitals, Health Systems, Healthcare Payers, Ambulatory Care Organizations
- Pricing
- Pricing was not clearly available from the provided evidence. Buyers should confirm current pricing on the vendor website.
- Key use cases
- Claims Processing Automation, Member Enrollment and Risk Scoring, Provider Revenue Cycle Management, Clinical Trial Coordination
- Official website
- www.trizetto.com
TriZetto is a healthcare administration platform developed by Cognizant. It is designed for health plans (payers), hospitals, and ambulatory care organizations to coordinate the business side of healthcare delivery.
The software supports several core functions, including revenue cycle management, provider reimbursement, and member enrollment. For providers, it supports managing the revenue cycle and virtual health scaling, while payers can use it for core administration and interoperability between disparate systems.
Buyers should confirm which specific modules they need, as the platform is split into distinct product lines for payers, providers, and life sciences, each with different capabilities for claims, care management, and data exchange.
Cognizant also provides consulting and cloud modernization services to help organizations integrate these tools into their operational workflows.
Key Features
An end-to-end platform designed to handle stages of the healthcare revenue cycle.
Tools like Facets and QNXT that help payers manage administrative functions across different lines of business.
Designed to connect different systems and reduce data silos for secure data access.
Includes tools like NetworX Modeler and Pricer to automate pricing scenarios.
Supports connections between care managers, members, and providers to personalize interventions.
Uses intelligent agents to support the automation of claims, care, and operations.
Use Cases
Using AI frameworks to support the automation of claims and operational workflows.
Managing Medicare and Medicaid enrollment, encounter submissions, and risk score tracking.
Supporting hospitals and ambulatory organizations in managing transactions and revenue optimization.
Connecting sponsors, sites, and technology providers via the Shared Investigator Platform.
Best For
Pricing
Pricing was not clearly available from the provided evidence. Buyers should confirm current pricing on the vendor website.
FAQ
It is designed for healthcare payers, providers, hospitals, and ambulatory care organizations.
It provides a platform to help providers manage the financial nuances of the revenue cycle and identify opportunities for optimization.
Yes, it utilizes a generative and agentic AI framework designed to support the automation of tasks in claims, care, and operations.
Source category: Healthcare
Source subcategory: Healthcare Revenue Cycle Management
