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What is TriZetto?

Accelerate payment procedures while reducing administrative burdens. With a network of over 8,000 payer connections and partnerships with more than 650 practice management providers, our claims management solutions significantly decrease the number of pending claims and lessen the reliance on manual processes. Claims for a wide range of services, such as professional, institutional, dental, and workers' compensation, can be sent efficiently and accurately, ensuring timely reimbursements. Address the changing landscape of healthcare consumerism by providing a seamless and transparent financial experience for patients. Our tools for patient engagement help facilitate informed conversations about eligibility and financial responsibilities, while also minimizing barriers that could negatively impact patient outcomes, ultimately enhancing the overall healthcare experience. By improving transparency and communication, we contribute to a more patient-centered approach in the healthcare industry.

What is RCM Edge?

RCM Edge is a cutting-edge revenue cycle management solution that utilizes artificial intelligence to optimize medical billing processes for various entities, including clinics, physician practices, hospitals, and larger health systems. The platform enhances the billing workflow, starting from eligibility checks all the way to ensuring reimbursements, and is designed to work seamlessly with existing electronic health record (EHR) and practice management tools. With Edge Verify, users can instantly validate insurance eligibility and benefits through a network of 566 payer connections. Additionally, Edge Claims provides real-time monitoring of claim statuses across 468 payer connections, standardizes the responses received from payers, and organizes claims requiring follow-up into designated queues, allowing staff to focus on more complex cases. By incorporating robotic process automation (RPA), predictive analytics, and providing real-time insights, this platform significantly reduces the manual effort required by staff. Although features like prior authorization, denial management, and accounts receivable follow-up are currently in the development phase and not yet live, RCM Edge is committed to continually advancing its capabilities. This ongoing evolution aims to further optimize the effectiveness and efficiency of revenue cycle management in the ever-changing healthcare landscape.

Media

Media

Integrations Supported

Motivity
Vetriq

Integrations Supported

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

$200/month
The Professional plan starts at $200 per month. A free 30-day trial is offered. Enterprise pricing is customized.
Free Version

Supported Platforms

SaaS

Supported Platforms

SaaS
On-Prem

Customer Service / Support

Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Online Training

Training Options

Documentation Hub
Online Training

Company Facts

Organization Name

TriZetto

Date Founded

1983

Company Location

United States

Company Website

www.trizettoprovider.com

Company Facts

Organization Name

ISpectra Technologies Global

Date Founded

2023

Company Location

United States

Company Website

rcmedge.ai/

Categories and Features

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