AdvancedMD Medical Billing vs TriZetto Healthcare RCM

AdvancedMD Medical Billing gives practices tools to handle claims, denials, payments, and collections in-house. Its workflow includes charge capture, eligibility verification, claims management, electronic remittance advice, patient payments, and collections. ClaimInspector checks claims for CCI, HIPAA, and LCD errors before they are submitted. Staff can use the A/R Control Center’s worklists and denial tracking to prioritize follow-up, while the Central Billing Office brings billing for multiple providers and locations into one system and login. Patients can pay online, and integrated credit card processing is supported. AdvancedMD also offers outsourced revenue cycle management and dedicated billing tools and pricing for medical billing service companies. The cloud-hosted software is accessible from internet-connected devices and offers an open API architecture; its partner marketplace lists more than 1,400 integration offerings. AdvancedMD says it maintains security controls for protected health information under the HIPAA Security Rule. Standard phone and email support is available 8 a.m. to 8 p.m. Eastern on normal business days; after-hours emergency help is available, with some incidents charged at $150. Pricing is paid, with no free plan and a 30-day trial. Listed monthly prices are $2,291,070 a month for the medical billing service company subscription and $4,291,070 a month for medical specialties software.

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.