How to use the Tizetto for patient eligibility. Step by step guide.

How we can check the Patient eligibility from the trizetto! Here you have complete guide about the Eligibility

What is TriZetto Provider Solutions?

TriZetto Provider Solutions is a company that offers revenue cycle management solutions for healthcare providers. It is the most common portal now a day for checking the eligibility of the patient on the DOS and claims management, patient engagement, analytics. It is also used for the clearing house before submission of the claims to the Insurance. It is very easy to check the patient eligibility before submitting the claim to the Insurance and got eligibility denials. It have more than 400 Insurance in the data base including the Medicare, Medicaid, Tricare, and lot of commercial insurances including Aetna, Cigna and BCBS.

How to get access of Trizetto provider solution.

Your provider or doctor provide you the basic portal you just need to login in to the portal by using the user name and password. No additional Information is required for the login. Any unauthorized person is not allow to use such portals because its HIPPA law violation.

In the following Figure you can see the login page:

Click on the login button and you will get access to the portal.

Now you will get different options. We are looking for the eligibility of the patient. Let’s try this!

 

How to check the Eligibility with Trizetto provider solution?

Whenever we need to check the eligibility of a patient, we require minimal data and trizetto portal give us access about the basic information of the patient health plan and benefits coverage. For example you have a patient who has UHC Insurance you need Patient name, Date of Birth, Member id and Date of service for checking the eligibility. All these information will be available in you EHRM (Electronic heath records management system). Now here is the example of patient eligibility verification.

A new screen will pop up!

Now. Select the Insurance/payer

Now enter the Data in the following form

Click on submit the eligibility inquiry you will be able to get the edibility of the patient. And next screen will tell you is patient is active or not on the Date of service.

 

Pros and Cons of Trizetto Providers solution.

TriZetto offers a comprehensive suite of solutions that cover the entire revenue cycle, from eligibility verification to patient engagement to analytics. It also integrates with various electronic health records (EHR) systems and practice management (PM) software to streamline workflows and data exchange.

TriZetto claims to have a high success rate of getting claims paid on the first submission, reducing denials and rejections, and increasing collections. It also provides dedicated support and training for its clients1.

TriZetto may not be the most affordable option for some providers, as it charges a percentage of collections rather than a flat fee or per-claim fee. It may also require a long-term contract and have hidden fees for some services.

TriZetto may not have the most advanced or user-friendly interface or features compared to some newer or more innovative solutions. It may also have some compatibility issues or bugs with certain systems or browsers

 

Conclusion:

No doubt Trizetto is the best and acceptable solution for the better and quick way of getting the eligibility of the patient. For the better revenue management you can use this.