# TriZetto Provider Solutions

> TriZetto Provider Solutions is a Cognizant-owned healthcare technology and services business that helps physician practices, health centers, hospitals and billing organizations manage claims, verify insurance eligibility, process remittances, collect patient payments and recover revenue.

- **Founded:** 1983
- **Headquarters:** Earth City, United States
- **Products:** Claims Management, Advanced Claim Editing, Revenue Cycle Management Services, Patient Engagement, Advanced Reimbursement Manager and Contract Manager
- **Notable:** Reports 98% average payer acceptance on its claims-management page., Bucksport case study reports 1.2% denials, under 1% rejections and 25 days in accounts receivable., UKSM-W case study reports roughly $100,000 more monthly collections following an operational change and TPS adoption.

## Products & services

- **Claims Management** — Claims transmission, status tracking, editing and remittance workflows.
- **Advanced Claim Editing** — AI, machine learning and automation intended to identify potential denials before submission.
- **Revenue Cycle Management Services** — Managed billing, certified coding and revenue recovery support.
- **Patient Engagement** — Eligibility, financial estimates, patient statements and payment tools.
- **Advanced Reimbursement Manager and Contract Manager** — Tools for identifying underpayments, managing recovery and evaluating payer contracts.
- **Credentialing with Pulse** — Guided credentialing and payer enrollment workflows with expert support.
- **Anesthesia Billing Software** — SaaS billing platform with per-user or per-transaction pricing.
- **Provider Clinical Data Exchange Solution** — FHIR-based SaaS data exchange for authorization, care gaps and risk adjustment.
- **Trading Partner Service** — Outsourced payer EDI and trading-partner management with per-member-per-month pricing.

## Achievements

- Reports 98% average payer acceptance on its claims-management page.
- Bucksport case study reports 1.2% denials, under 1% rejections and 25 days in accounts receivable.
- UKSM-W case study reports roughly $100,000 more monthly collections following an operational change and TPS adoption.

## Latest updates

- **2025-12** — A December 17 letter to OCHIN described containment of suspicious activity detected October 2, Mandiant’s investigation and remediation, and planned notification support.
- **2026-01** — TPS’s December letter said affected-provider notifications would begin on or around January 5, subject to consent and required information; this is the announced schedule.

## Links

- Website: https://www.trizettoprovider.com/
- LinkedIn: https://www.linkedin.com/company/trizettoprovider
- Twitter/X: https://twitter.com/TZProvider
- YouTube: https://www.youtube.com/@TriZettoProvider
- Facebook: https://www.facebook.com/TriZettoProvider/

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Profile page: https://yespress.io/trizetto-provider-solutions
Published by YesPress — https://yespress.io
Last updated: 2026-10-02