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TriZetto Healthcare RCM
Teaneck, New Jersey, United States
What it is
TriZetto Healthcare RCM is Cognizant’s web-based revenue cycle management offering for hospitals, health systems and ambulatory care organizations. Its coverage runs from patient access and eligibility enrollment through 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. The clearinghouse supports claim submission and tracking, status inquiries, remittance conversion to EDI 835 files and payment-process support. Cognizant lists more than 8,000 payer connections, 650+ electronic medical record integrations and partnerships with 650+ practice-management vendors. Denials technology can identify professional and institutional denial risks, streamline appeals and payer follow-up, and provide analytics. Revenue Cycle Management Workflow prioritizes accounts by payer, amount and age, while ARM Pro identifies common rejection causes. Patient engagement includes insurance discovery, prior-authorization support and flexible payments. Analytics provide dashboards, issue identification and benchmarking. The clearinghouse is described as SOC 2 compliant and HITRUST and EHNAC accredited. Pricing is on request.
For and against
For
- End-to-end revenue cycle coverage
- More than 8,000 payer connections
- 650+ electronic medical record integrations
- Denials appeals and follow-up tools
- SOC 2, HITRUST and EHNAC credentials
Against
- Pricing is on request
- Focused on listed healthcare provider types
- Web platform only
The verdict
TriZetto Healthcare RCM brings patient access, claims, payment and denial functions into one web-based offering. Its extensive integrations and compliance credentials are relevant to healthcare organizations, but buyers must request pricing.
Who it suits
TriZetto Healthcare RCM is aimed at hospitals, health systems and ambulatory care organizations managing provider revenue cycles. It suits organizations needing combined claims, eligibility, payments and denials workflows.
Plans and prices
TriZetto Healthcare RCM
Pricing not stated on the product pages; contact Cognizant for details
Read 9 Oct 2026 · cognizant.com
On the record
- Analytics
- RCM analytics tools provide dashboards and interfaces, issue identification, comparative benchmarking and data for strategic decisions.cognizant.com · read 9 Oct 2026
- Claims features
- The TriZetto clearinghouse supports claim submission and tracking, claim status inquiries, remittance conversion to EDI 835 files and reduced rejection rates.cognizant.com · read 9 Oct 2026
- Claims management
- The clearinghouse claims tools can automate claim status inquiries, convert EOBs to standard EDI 835 files and track claims from submission to payment.cognizant.com · read 9 Oct 2026
- Clearinghouse connections
- The clearinghouse page states that its claims management solutions have 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors.cognizant.com · read 9 Oct 2026
- Denials management
- The denials management technology can identify potential professional and institutional denials, streamline appeals and payer follow-up, and provide business intelligence and analytics.cognizant.com · read 9 Oct 2026
- Denials workflow
- Cognizant Revenue Cycle Management Workflow prioritizes accounts using payer, amount and age, while TriZetto ARM Pro automates identification of common claim rejection causes.cognizant.com · read 9 Oct 2026
- Eligibility and enrollment
- Eligibility enrollment services include screenings, financial counseling and application support for Medicaid, Medicare and charity programs.cognizant.com · read 9 Oct 2026
- Integrations
- Cognizant reports 650 EHR system integrations and longstanding partnerships with more than 650 practice management vendors for its claims management solutions.cognizant.com · read 9 Oct 2026
- Notable limits
- The RCM page’s filter identifies hospitals and health systems and ambulatory care organizations as its provider types.cognizant.com · read 9 Oct 2026
- Patient access
- Patient access services use technology to address staffing resource deficiencies, simplify front-end interactions and increase patient financial clearance.cognizant.com · read 9 Oct 2026
- Patient engagement
- Patient engagement features include eligibility verification, discovery of hidden insurance coverage, prior authorization support and flexible payment options.cognizant.com · read 9 Oct 2026
- Payer connections
- The claims management page states the service has more than 8,000 payer connections.cognizant.com · read 9 Oct 2026
- Results example
- Cognizant reports that its work with MetroHealth using RCM Workflow and ARM Pro was associated with a 30% decrease in denied claims and $13 million in additional revenue over one year.cognizant.com · read 9 Oct 2026
- Revenue cycle coverage
- The RCM page describes an end-to-end set of services and products, including patient access, eligibility enrollment, coding, clearinghouse, accounts receivable and denials management.cognizant.com · read 9 Oct 2026
- Revenue cycle experience
- Cognizant says it has over 30 years in RCM and processes 2.6 billion transactions annually, supporting more than 200 million lives.cognizant.com · read 9 Oct 2026
- Security and accreditation
- Cognizant describes its clearinghouse as SOC 2 compliant and HITRUST and EHNAC accredited.cognizant.com · read 9 Oct 2026
- Security and compliance
- The clearinghouse page describes its solution as SOC 2 compliant, HITRUST accredited and EHNAC accredited.cognizant.com · read 9 Oct 2026
- Support
- Cognizant says its clearinghouse service provides technical support to healthcare providers navigating payment processes.cognizant.com · read 9 Oct 2026
