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Clearinghouse Support

TriZetto Claims Support Services

Outsourced billing support for practices submitting through Cognizant TriZetto Provider Solutions (TPS).

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Quick Answer

What are TriZetto claims support services?

TriZetto claims support services are outsourced billing work performed through a practice's Cognizant TriZetto Provider Solutions connection — claim submission, clearinghouse-rejection correction, eligibility verification, and remittance retrieval and posting — so the EDI transactions flowing through TriZetto are actually worked.

  • TriZetto is now Cognizant TriZetto Provider Solutions (TPS), a major clearinghouse/EDI network
  • It transports eligibility, claims, and remittance — it does not work them
  • We submit, correct rejections, verify eligibility, and post remittances through TriZetto
  • Clearinghouse support that pairs with full billing
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TriZetto — now Cognizant TriZetto Provider Solutions (TPS) — is a major clearinghouse and EDI network that moves eligibility, claims, and remittance between practices and payers. Like any clearinghouse, it does the transport, not the work: claims still reject at the front end, eligibility still has to be checked, and remittances still have to be retrieved and posted. Practices connected to TriZetto often leave that work half-done because it sits between the EHR and the payer where no one owns it. MedPrecision works the billing that flows through your TriZetto connection — submitting and correcting claims, clearing rejections, verifying eligibility, and posting remittances — so the EDI network is actively worked instead of merely connected.

Who This Service Is For

Practices submitting claims or verifying eligibility through TriZetto (TPS) Offices with TriZetto rejections and unretrieved remittances accumulating Providers whose billing falls into the gap between EHR and clearinghouse Practices that want their TriZetto connection worked as part of full billing

What Is Breaking Right Now

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Claims stuck in TriZetto rejection reports, counting as unbilled

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Eligibility not verified through TriZetto, driving avoidable denials

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Remittances delivered through TriZetto but never retrieved or posted

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The EDI network connected but under-operated for lack of staff

What We Handle

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Claim submission through TriZetto

We submit claims through your TriZetto connection and resolve edits before they reach the payer, so first-pass acceptance improves instead of claims returning as clearinghouse rejections.

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Rejection resolution

TriZetto front-end rejections never reach the payer and never pay until corrected. We work the rejection reports and resubmit, so those claims stop counting as silently unbilled revenue.

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Eligibility & benefits verification

We run eligibility and benefits checks through TriZetto's EDI before appointments, so claims aren't denied for coverage the practice could have confirmed up front.

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Remittance retrieval & posting

We retrieve electronic remittances through TriZetto and post them against expected reimbursement, catching underpayments and unretrieved payments the network delivers but no one collects.

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Work your TriZetto connection, don't just maintain it

Get a free review of your TriZetto rejections, eligibility, and remittances — we'll show you the revenue moving through the EDI network that no one on your side is working.

What Reporting and Visibility Looks Like

Transparency is built into every engagement. You will always know where your revenue stands and what actions are being taken on your behalf.

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Monthly KPI Dashboards

Track collection rates, denial trends, days in A/R, and payer-level performance with dashboards delivered on a fixed schedule.

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Real-Time Claim Tracking

See claim status updates in real time so you never have to wonder where a payment stands or when follow-up is happening.

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Quarterly Business Reviews

Detailed reviews with actionable recommendations covering denial root causes, payer trends, and revenue recovery opportunities.

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Proactive Alerts

Automated alerts when key metrics shift, so issues are caught and addressed before they affect your bottom line.

Glossary

TriZetto Claims Support | Clearinghouse Billing Services Key Terms

Cognizant TriZetto Provider Solutions (TPS)
A major US healthcare clearinghouse and EDI network, formerly TriZetto and now part of Cognizant, handling eligibility, claim, and remittance transactions between providers and payers.
EDI network
The electronic data interchange system that transports standardized healthcare transactions (eligibility, claims, remittance) between providers and payers. It moves the data but does not work the billing.

Common Questions

Common questions about trizetto claims support | clearinghouse billing services.

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What is TriZetto's current name?

The provider-facing business is Cognizant TriZetto Provider Solutions (TPS), reflecting TriZetto's acquisition by Cognizant. It operates as a healthcare clearinghouse and EDI network handling eligibility, claims, and remittance for providers.

Can you work claims through my TriZetto connection?

Yes. We operate through your existing TriZetto (TPS) connection — submitting and correcting claims, clearing rejections, verifying eligibility, and posting remittances. There is no new software; we work the network your practice already uses.

What is a TriZetto clearinghouse rejection?

A clearinghouse rejection is a claim stopped by TriZetto before it reaches the payer, due to a format or edit error. It never adjudicates or pays until corrected and resubmitted, which is why unworked rejection reports quietly become unbilled revenue.

Do I have to switch clearinghouses to use your billing?

No. We work whichever clearinghouse your practice uses, including TriZetto. If your payers and EHR route through TriZetto, we work it there; the point is that the claims, rejections, and remittances get worked wherever they flow.

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Work your TriZetto connection, don't just maintain it

Get a free review of your TriZetto rejections, eligibility, and remittances — we'll show you the revenue moving through the EDI network that no one on your side is working.

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