Top 8 TriZetto Alternatives & Competitors 2024

In today's dynamic healthcare landscape, healthcare organizations are leveraging revenue cycle management (RCM) software to manage various aspects of their revenue cycle. RCM software like TriZetto offers many functionalities, including automating eligibility verification, providing patient cost estimates, real-time reporting and analytics tools, and managing patient billing and collections. 

However, your healthcare organization has distinct billing needs, and another RCM software may be a better fit. While we recognize TriZetto's capabilities, other RCM solutions may offer more unique features, be more intuitive, provide better customer service, or provide a superior patient experience. By considering TriZetto alternatives, you can make an informed decision and ensure you use a solution that is designed for healthcare organizations like yours. 

Who are TriZetto Provider Solutions, and What Markets do They Serve?

TriZetto Provider Solutions is a healthcare technology company that provides revenue cycle management tools for healthcare organizations. It was founded in 1984 as Gateway EDI. It processed its 5 millionth claim in 2006, and TriZetto acquired it in 2011. In 2014, Cognizant, an IT company, acquired TriZetto and added it to its stack of software solutions for the healthcare industry.

TriZetto’s products and services help healthcare organizations manage their finances through billing automation, payment processing, and claims management. Their solutions help to improve administrative efficiency for both payers and providers.

Key Features of TriZetto Software:

• Claims Management Tools: TriZetto's software can help you automate your claims processing and submission process. The tools help to simplify the claims and remittance process, reduce rejection rates, and track claims from submission to payment.
• Patient Engagement Solutions: These help you provide a more informed patient service. You can verify eligibility, help patients understand their financial responsibility, and collect more money upfront. 
• Denial and Contract Management Tools: These solutions help to identify denials, underpayments, and errors and automate the appeal process. You can also audit payers' contracts to ensure compliance. 
• Analytics and Reporting Solutions: With TriZetto's analytics feature, you can gain valuable insight into your revenue cycle KPIs, identify issues, and make data-backed decisions. The advanced dashboards and interface make it easy to understand your data and have increased visibility into your revenue cycle. 

Markets Served by TriZetto:

TriZetto serves a wide range of healthcare organizations, including:

• Hospitals and health systems: TriZetto serves health systems, helping them with a fully integrated workflow that integrates well with Epic and minimizes revenue leakage. 
• Hospitals and community health centers: The company helps hospitals with tools that promote revenue recovery and improve patient engagement.
• Physician practices: The solution helps individual and group physician practices with revenue cycle management for more efficient billing and collection. 
• Payers: TriZetto also serves payers and helps them reduce treatment costs, increase patient engagement, and achieve more efficient claim adjudication. 

List of Top TriZetto Alternatives

• MD Clarity
• Change Healthcare
• DrChrono
• TruBridge
• Infinx
• Dentrix
• Waystar
• StrataPT

Top 8 Alternatives and Competitors to TriZetto

Here's a summary of the top eight TriZetto competitors:

1. MD Clarity

Description

MD Clarity was founded in 2010, and it is driven by the belief that patients deserve to know the financial implications of their health care costs upfront. Its goal is to help providers get accurate payment for the services they provide. The company’s solutions help providers improve patient experience and their bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place. MD Clarity serves various healthcare organizations, such as ambulatory healthcare practices, managed services organizations, and health systems.

Features in common with TriZetto

Here are the MD Clarity features and their similarity with TriZetto:

• Clarity Flow: This tool helps healthcare providers offer a transparent patient experience by providing accurate out-of-pocket cost estimates, enabling providers to collect more upfront payments. You can also use this tool to send patients' Good Faith Estimates automatically via email, letter, or text and allow them to make upfront deposits and payment plan elections online. Clarity Flow is a combination of TriZetto's Patient Responsibility Estimation and Patient Payment. 
• Contract Analytics: MD Clarity's Contract Analytics tool is similar to TriZetto's Contract Management tool. Contract Analytics helps you see your payers' contract performance, compare payers' contract performance, and project how contract changes will affect your bottom line. 
• RevFind: This tool helps providers automatically detect, correct, and appeal underpayments and denials from payers. You can also assign appeals to staff and view the task status in one place. With RevFind, you can identify underpayment patterns, analyze payer contracts performance, and negotiate better contracts. RevFind provides similar functionalities as TriZetto's Denial Management.

2. Change Healthcare

Description

Change Healthcare delivers innovative solutions that help improve the healthcare journey. The company serves a wide range of healthcare organizations, including payers, providers, third-party administrators, and pharmacies. Change Healthcare provides revenue cycle management, payment cycle management, and health information exchange solutions that connect providers, payers, and patients. 

Features in common with TriZetto

Change Healthcare shares similar features with TriZetto, including:

• Payment Accuracy Solutions: These tools help to improve payment integrity, automate claims adjudication, improve payment accuracy, and reduce appeals. Like TriZetto's Claim Management, they help increase medical and administrative savings and improve provider satisfaction. 
• Revenue Cycle Management: These solutions improve staff efficiency, optimize revenue, and elevate patient engagement. They improve financial performance by providing transparency, boosting coding accuracy, improving clinical documentation to increase speed to payment, and accelerating reimbursement. 
• Revenue Cycle Analytics Solution: With these tools, you can get a comprehensive view of your revenue cycle, which will enable you to make timely and data-backed decisions to optimize staff productivity, financial outcomes, and the patient experience. You can also compare your key performance indicators (KPIs) with industry benchmarks and industry top performers.

Ratings

Change Healthcare has a score of 3.8/5 stars on G2.

3. DrChrono

Description

DrChrono is a healthcare technology company with solutions that help practices create and manage electronic health records (EHR), medical billing, revenue cycle management, and practice management. It provides customizable EHR medical forms and charting shortcuts tailored for over 20 specialties. The aim is to help doctors practice medicine and leverage technology to handle the administrative side. Its web-based platform helps practices increase efficiency and reduce error and is accessible via iPads, iPhones, and, of course, desktops.

Features in common with TriZetto

DrChrono has these features in common with TriZetto:

• Medical Billing Solutions: These tools maximize revenue collection by integrating EHRs, practice management systems, and clearinghouses to address all practice billing needs. You can achieve higher payment collection rates, higher clean claim rates, and low denial rates. These solutions are comparable to TriZetto's Billing and Coding.
• Medical Coding Solutions: These perform similar functions to TriZetto's Billing and Coding. You can set up your most common diagnosis and medical billing codes, thereby reducing data entry and increasing your coding accuracy. You also get access to Dr. Chron's team of certified medical coders.
• Revenue Cycle Management: This solution will take over time-consuming tasks in your RCM and provide quality services at a reduced cost, thereby helping you to have a stable income and more time to provide patient care. DrChron’s team of billing experts, certified medical coders, and in-house coding compliance officers will handle your medical claims from start to finish. The result will be improved clean claim rates, a faster turnaround on denials, and improved cash flow. 

Ratings

DrChrono has a rating of 3.6/5 stars on G2.

4. TruBridge

Description

TruBridge is a healthcare services company that provides diverse revenue cycle management solutions to healthcare organizations of all sizes. Their RCM products and services help healthcare organizations boost productivity, increase cash flow, speed up reimbursement, and allow healthcare workers to focus on care. Their goal is to help healthcare companies handle their business and administrative sides.

Features in common with TriZetto

TruBridge shares these features with TriZetto:

• Medical Coding Service: This solution is designed to help you improve cash flow, reduce risks, and decrease expenses by getting your coding correct at the first instance through TruBridge's full or partial outsourcing solution. 
• Patient Liability Estimates (PLE): This allows you to provide patients with approximate out-of-pocket expenses before service delivery. With PLE, you can increase point-of-service collections, reduce bad debt, and improve patient satisfaction.
• Eligibility Verification: This automates eligibility checking at the point of registration and provides answers within seconds. It can reduce claim denials and carrier rejections and improve customer service. 
• Claim Scrubbing and Submission: This is similar to TriZetto's Claim Management. It helps reduce claim processing time and accelerate payment by identifying errors before claim submission. This results in higher clean claim rates and reduces the administrative burden on your staff.

Ratings

TruBridge has a rating of 3.4/5 on G2.

5. Infinx

Description

Infinx Healthcare provides revenue cycle management solutions to help healthcare providers overcome revenue cycle challenges through the power of artificial intelligence and automation. By using Infinx’s comprehensive technology and team of experts, healthcare organizations can improve patient access and accelerate reimbursements.

Features in common with TriZetto

Infinx Healthcare has similar features to TriZetto. They include:

• Patient Access: These solutions help providers automate financial clearance and prior authorizations before service delivery so they can provide care faster. From the same dashboard where you input prior authorization requests, you can also perform eligibility verifications, insurance discovery, benefit checks, patient out-of-pocket estimations, and CDSM consults. Infinx’s Patient Access is similar to TriZetto’s Patient Engagement. 
• Medical Coding: You can increase your organization’s clean claim submission rate and reduce denials caused by coding errors by using Infinx’s onshore and offshore expert medical coders enabled by the latest technology.
• Revenue Acceleration: Leverage AI and automation to get faster claim reimbursements, decrease cost-to-collect, avoid underpayments, and reduce denials with Infinx’s cloud-based A/R Recovery and Denial Management platform.

Ratings

Infinx has a score of 91.1 on KLAS Research.

6. Dentrix

Description

Dentrix is a dental practice management software created specifically for dental clinics. The platform combines practice technology with business management tools, including billing and collection solutions. 

Features in common with TriZetto

Dentrix shares these features with TriZetto:

• Dentrix QuickBill PremiumTM: This is your all-in-one solution to accelerate cash flow by sending patient billing statements and collecting payment. You can notify patients individually or in batches via email, text, or mail. 
• Dentrix eClaimsTM: This solution helps you reduce reimbursement time by automating claim validations and submissions. It also allows you to add attachments, such as photos, digital radiographs, and other documents, to support your claims. 
• Dentrix Insurance ManagerTM: This tool helps you save time by automating eligibility verification before appointments and monitoring reimbursements in real time. Its advanced claim reporting tools will notify you immediately if a claim is accepted or denied. 

Ratings

Dentrix has a rating of 4/5 stars on G2.

7. Waystar

Description

Waystar is a healthcare technology company that simplifies healthcare payments across the complete revenue cycle. The company began in 1999 as ZirMed. Navicure merged with ZirMed in 2018 to form Waystar. The technology serves health systems, hospitals, and physician and specialty practices, such as hospice care, skilled nursing, and ambulatory surgery centers.

Features in common with TriZetto

Waystar offers several RCM solutions, including:

• Financial Clearance: This tool automates eligibility verification, provides patient payment estimates, and gives providers visibility into patients propensity to pay, thereby increasing reimbursement rates and upfront payment and reducing denial rates. 
• Claim Management: Waystar's Claim Management is an award-winning solution to help prevent rejections and denials, automate claim monitoring, and streamline attachments. It is the only platform that allows you to handle government and commercial claims in one place.
• Revenue Capture: You can use this tool to recover more revenue and save work hours using machine learning, predictive analysis, and a team of certified skilled coders to identify and correct coding errors. 

Ratings

Waystar has a rating of 4.5/5 stars on G2.

8. StrataPT

Description

StrataPT is an EMR and RCM company that helps occupational, speech, and physical therapists simplify workflow, increase revenues, and improve patient experience. The company prioritizes delivering world-class customer service to better understand and serve its clients.

Features in common with TriZetto

StrataPT has the following features:

• Online Bill Pay and Clarity Panel: Use these tools to provide transparency in billing. You can schedule real-time electronic statements for your patients and provide them with a seamless way to pay their invoices through text or email. 
• End-to-End Billing and RCM: Automate your revenue cycle from start to finish. Run eligibility verification, submit claims, and view their status until you receive payment. This tool also integrates billing and clinical documentation to increase reimbursement. 

Ratings

StrataPT has received a rating of 4/5 stars on Software Advice and 5/5 stars on Software Finder.

See the Best Alternative in Action

Check out MD Clarity if you’re looking for EMR or RCM software like TriZetto. MD Clarity has impressive features that can help you improve patient experience, increase revenue, and reduce staff workload by providing accurate patient cost estimates, optimizing contracts, and detecting payer underpayments all in one central location. With MD Clarity's Clarity Flow, Contract Analytics, and RevFind, you'll have a suite of tools with similar capabilities as TriZetto's RCM. 

Book a personalized demo today to experience firsthand how MD Clarity compares to TriZetto.

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