Claims

Get paid quickly and accurately.

With efficient billing processes, you can develop a strong cash flow and in turn create a healthier bottom line. That means you can reinvest money into your practice, better serve your patients, and enable better patient outcomes. Unfortunately, growing patient financial responsibility, declining reimbursement rates, and new regulations can make getting paid difficult.

Our claims management solutions are here to make revenue management easier.

Our claims management solutions are here to make revenue management easier. From smooth integration with your current workflow to direct connections with thousands of payers, our electronic claims, paper claims, and secondary claims solutions simplify the submission and remittance process. Our claims editing solutions review claims for common errors so you can fix mistakes before they impact your practice. With our claim status inquiry solution, you can always find out the status on previously submitted claims. We also provide reports that help you identify and ultimately correct issues and procedures that are creating inefficiencies within your organization.

Additionally, we can help you submit claims for worker’s compensation, personal injury, and auto accidents, as well as direct data entry solutions. We can also help you identify your risk of being audited by government entities and private payers. 

Flexible packages options are available to fit the needs of any-size business. Browse our package options.


Claims Solution Details:
Claims Editing
Work Comp

See how TriZetto Provider Solutions can help you.

TriZetto is very good to work with. I am able to get a hold of them right away and I am on a first name basis with many of them. They help me with electronic remittance set-up and notify me of errors right away so I can correct my mistakes. TriZetto goes above and beyond to help me in a timely fashion, and if the person I am working with cannot answer my questions they know someone who can.
Nikki Harmon — Stat Billing, LLC, Castroville, TX

Payer List

Our solutions are integrated with more than 3,400 payers so you can easily incorporate our solutions into your business. If you don’t see a payer on our list, contact us and we can likely add them.

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Our Packages

Our ultimate goal is to help you boost revenue. We achieve our goal by helping you work as efficiently as possible, eliminating paperwork and automating your most time-consuming and error-prone tasks.

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What’s New in Diagnosis Coding? Risk Adjustment for Physician Practices

Many practices are part of, or soon will be part of, Accountable Care Organizations (ACO) or other Alternative Payment Models (APM). These payment models will provide bonuses or penalties, based partially on the severity of the practice’s patient population. The payer uses diagnosis codes submitted on claims to determine this severity. Payments for individual physician services are based on CPT code, but now, accurately reporting co-morbidities and underlying medical conditions will affect reimbursement for physician practices.

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