Patient Access

Increase the likelihood of getting paid and improve the patient experience.

As insurance grows more complicated and the number of patients using high-deductible plans increases, providers need to reduce the risk of costly rejections and denials. Through our patient access solutions, we can help you take the necessary steps to determine patient’s eligibility and financial liability estimation.

providers need to reduce the risk of costly rejections and denials

By verifying insurance and benefits before you provide services, you can help avoid some of the most common reasons for claim rejections and denials: invalid or incorrect patient insurance eligibility. Additionally, this information, along with patient liability estimation, enables you to establish financial expectations with patients – and avoid unpleasant surprises on both sides.


Patient Access Solution Details:
Patient Eligibility
Patient Responsibility Estimation

See how TriZetto Provider Solutions can help you.

I want to personally thank the entire TriZetto Provider Solutions team for great customer service I receive. My questions are quickly answered and any issues are promptly corrected.
Peggy — Hillcrest Eyecare, Simpsonville, SC

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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