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SPECIFICTION
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TriZetto Healthcare RCM

cognizant.com

Web
Visit cognizant.com
Spec score 7.1 #21 of 28 in Medical Billing Software

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 services address staffing shortages, front-end interactions, and financial clearance. Eligibility work includes screenings, counseling, and application support for Medicaid, Medicare, and charity programs. Clearinghouse tools submit and track claims, answer status inquiries, convert remittances to EDI 835 files, and connect with more than 8,000 payers. Cognizant reports 650+ electronic medical-record integrations. Revenue Cycle Management Workflow prioritizes accounts by payer, amount, and age, while ARM Pro identifies common rejection causes. Denials tools support potential professional and institutional denial identification, appeals, payer follow-up, and analytics. Patient engagement includes eligibility verification, hidden-coverage discovery, prior-authorization support, and payment options. The clearinghouse is described as SOC 2 compliant and HITRUST and EHNAC accredited. Pricing is on request.

Spec sheet

What it does
Cognizant describes its RCM offering as an end-to-end platform combined with a flexible service model for revenue cycle needs.Read 9 Oct 2026 · cognizant.com
Integrations
Cognizant reports 650 EHR system integrations and longstanding partnerships with more than 650 practice management vendors for its claims management solutions.Read 9 Oct 2026 · cognizant.com
Support
Cognizant says its clearinghouse service provides technical support to healthcare providers navigating payment processes.Read 9 Oct 2026 · cognizant.com
Headquarters
Teaneck, New Jersey, United StatesRead 28 Sep 2026 · cognizant.com
Founded
1994Read 28 Sep 2026 · cognizant.com
Analytics
RCM analytics tools provide dashboards and interfaces, issue identification, comparative benchmarking and data for strategic decisions.Read 9 Oct 2026 · cognizant.com
Claims features
The TriZetto clearinghouse supports claim submission and tracking, claim status inquiries, remittance conversion to EDI 835 files and reduced rejection rates.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
Clearinghouse connections
The clearinghouse page states that its claims management solutions have 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
Eligibility and enrollment
Eligibility enrollment services include screenings, financial counseling and application support for Medicaid, Medicare and charity programs.Read 9 Oct 2026 · cognizant.com
Notable limits
The RCM page’s filter identifies hospitals and health systems and ambulatory care organizations as its provider types.Read 9 Oct 2026 · cognizant.com
Patient access
Patient access services use technology to address staffing resource deficiencies, simplify front-end interactions and increase patient financial clearance.Read 9 Oct 2026 · cognizant.com
Patient engagement
Patient engagement features include eligibility verification, discovery of hidden insurance coverage, prior authorization support and flexible payment options.Read 9 Oct 2026 · cognizant.com
Payer connections
The claims management page states the service has more than 8,000 payer connections.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
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.Read 9 Oct 2026 · cognizant.com
Security and accreditation
Cognizant describes its clearinghouse as SOC 2 compliant and HITRUST and EHNAC accredited.Read 9 Oct 2026 · cognizant.com
Security and compliance
The clearinghouse page describes its solution as SOC 2 compliant, HITRUST accredited and EHNAC accredited.Read 9 Oct 2026 · cognizant.com
Who it serves
The RCM page lists hospitals, health systems and ambulatory care organizations as provider types.Read 9 Oct 2026 · cognizant.com

Plans and prices

TriZetto Healthcare RCM Priced on request Pricing not stated on the product pages; contact Cognizant for details Read 9 Oct 2026 · cognizant.com

Every TriZetto Healthcare RCM plan and price →

Strong points and limits

Strong points

  • End-to-end revenue-cycle coverage
  • More than 8,000 payer connections
  • 650+ electronic medical-record integrations
  • Denials workflow and appeals support
  • SOC 2, HITRUST, and EHNAC credentials

Limits

  • Pricing requires contacting Cognizant
  • Provider scope lists three organization types
  • Web platform only

Who it suits

It is aimed at hospitals, health systems, and ambulatory care organizations managing end-to-end revenue cycles. Organizations needing clearinghouse connections, denials workflows, eligibility services, and patient payments are within its stated scope.

Verdict

TriZetto Healthcare RCM combines services and software across patient access, claims, payments, and denials. Its broad integrations and compliance credentials are paired with request-based pricing.

Where Specifiction places it

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