EZClaim vs TriZetto Healthcare RCM

EZClaim provides medical billing and scheduling software for small to medium-sized provider offices and outsourced medical billing firms. It supports CMS 1500 professional and UB-04 institutional charges, with electronic claim submission, claim status verification, real-time eligibility, ERA auto posting, and customizable reporting. EZClaim Scheduling can be used with EZClaim Billing or on its own, and appointments can be converted into claims. Listed integration partners include TriZetto, Waystar, Availity, Amazing Charts, Practice Fusion, and WebPT. EZClaim Billing is described as HIPAA compliant and includes user authentication. EZClaim Cloud is accessed over the internet; the maker says it works on Mac and PC and lists nightly backups, protected server storage, support, and updates. The Portal offers read-only access to EZClaim data with access controls and activity logs. The first-user annual plan costs $189 a month, billed annually; the monthly plan costs $199 a month, billed monthly. Each includes 1 GB of storage, and additional clearinghouse fees may apply.

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.