List of Cognizant TriZetto Provider Solutions Customers
Teaneck, 7666, NJ,
United States
Since 2010, our global team of researchers has been studying Cognizant TriZetto Provider Solutions customers around the world, aggregating massive amounts of data points that form the basis of our forecast assumptions and perhaps the rise and fall of certain vendors and their products on a quarterly basis.
Each quarter our research team identifies companies that have purchased Cognizant TriZetto Provider Solutions for Payment Integrity from public (Press Releases, Customer References, Testimonials, Case Studies and Success Stories) and proprietary sources, including the customer size, industry, location, implementation status, partner involvement, LOB Key Stakeholders and related IT decision-makers contact details.
Companies using Cognizant TriZetto Provider Solutions for Payment Integrity include: Denver Health and Hospital Authority, a United States based Insurance organisation with 8300 employees and revenues of $1.35 billion, EmblemHealth, a United States based Insurance organisation with 3000 employees and revenues of $1.00 billion and many others.
Contact us if you need a completed and verified list of companies using Cognizant TriZetto Provider Solutions, including the breakdown by industry (21 Verticals), Geography (Region, Country, State, City), Company Size (Revenue, Employees, Asset) and related IT Decision Makers, Key Stakeholders, business and technology executives responsible for the software purchases.
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight | Insight Source |
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Denver Health and Hospital Authority | Insurance | 8300 | $1.4B | United States | Cognizant | Cognizant TriZetto Provider Solutions | Payment Integrity | 2019 | n/a | In 2019 Denver Health and Hospital Authority implemented Cognizant TriZetto Provider Solutions to support Payment Integrity workflows focused on real time eligibility verification. The deployment was designed to support Real Time Eligibility or RTE 270 transactions, enabling providers to verify member eligibility at the point of service through TriZetto Provider Services infrastructure. This implementation positions Cognizant TriZetto Provider Solutions as the central eligibility intake and response engine for provider relation processes. Configuration centered on RTE transaction handling and provider onboarding for real time requests, including configuration for submit and response routing. Denver Health configured Cognizant TriZetto Provider Solutions to accept 270 transaction submissions from providers with existing TPS connections and to provision new connections for providers working through clearinghouses. The vendor provided setup and training pathways to enable providers to run real time transactions, reflecting standard Payment Integrity functional workflows for eligibility adjudication and response delivery. Integrations and operational coverage included direct connections from providers and indirect connections via clearinghouses, with explicit procedures for clearinghouses to request TPS setup on behalf of providers. Operational stakeholders include Provider Relations, Member Services, Claims, and IS teams, with the application serving provider networks and the provider relations function across Denver Health Medical Plan. The implementation required coordination between provider clearinghouses and TriZetto Provider Services to establish connectivity and transaction routing. Governance and operational processes were defined for onboarding and troubleshooting, TriZetto Provider Services owning the connectivity relationship for RTE transactions while Member Services retained responsibility for investigating content level issues. Providers and clearinghouses are instructed to contact TPS Sales Support at physiciansales@trizetto.com or 800-969-3666 to request setup and training when no existing connection is present. For issues receiving transactions providers escalate to TPS, and for suspected content issues Member Services engages Claims and IS teams to review responses and resolve discrepancies. | |
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EmblemHealth | Insurance | 3000 | $1.0B | United States | Cognizant | Cognizant TriZetto Provider Solutions | Payment Integrity | 2018 | n/a | In 2018, EmblemHealth implemented Cognizant TriZetto Provider Solutions as its preferred electronic claims channel, aligning this deployment with the Payment Integrity application category. Cognizant TriZetto Provider Solutions was positioned as a primary EDI clearinghouse and provider solution to centralize electronic claim intake and standardized transaction processing for the payer. The implementation focused on EDI transaction processing and adjudication workflows, including support for ASC X12N 837 professional, institutional, and dental claim transmissions, ASC X12N 270/271 eligibility benefit inquiry and response, and ASC X12N 276/277 claim status request and response, all under HIPAA ASC X12N Version 5010 standards. The deployment also incorporated electronic Coordination of Benefits handling consistent with national COBA processes for Medicare Part A and Part B crossover claims, and operational rules enforcing member ID formats and NPI and taxonomy requirements. Operational integration explicitly covered connections from practice management systems, billing services, and third party clearinghouses, with existing clearinghouses such as Ability, SSI, Availity, and Claim Logic continuing to route claims to EmblemHealth without change. EmblemHealth published transaction specific companion guides and onboarding instructions for vendors and clearinghouses, and provided a direct enrollment pathway to connect to TPS for free, preserving standard interoperability with provider billing vendors and clearinghouse partners. Governance and process controls emphasized claims submission hygiene and automated billing configuration, with provider guidance to avoid duplicate submissions, automatic re billing, and inadvertent paper claim generation, and with requirements that attachments are not supported electronically at the time of rollout and will be requested manually when needed. The implementation narrative links Cognizant TriZetto Provider Solutions Payment Integrity deployment to explicit benefits noted by EmblemHealth, including lower per claim cost, faster submission and reimbursement cycles, simplified record keeping, and reduced administrative burden for provider offices. |
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