TriZetto Claims Support Services
Outsourced billing support for practices submitting through Cognizant TriZetto Provider Solutions (TPS).
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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
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
What Is Breaking Right Now
Claims stuck in TriZetto rejection reports, counting as unbilled
Eligibility not verified through TriZetto, driving avoidable denials
Remittances delivered through TriZetto but never retrieved or posted
The EDI network connected but under-operated for lack of staff
What We Handle
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.
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.
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.
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.
Free Billing Audit · No obligation
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.
Monthly KPI Dashboards
Track collection rates, denial trends, days in A/R, and payer-level performance with dashboards delivered on a fixed schedule.
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.
Quarterly Business Reviews
Detailed reviews with actionable recommendations covering denial root causes, payer trends, and revenue recovery opportunities.
Proactive Alerts
Automated alerts when key metrics shift, so issues are caught and addressed before they affect your bottom line.
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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Get a Free Billing Audit arrow_forwardWhat 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.
Related Services
Specialties We Serve
Related Resources
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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