trizetto

JSON twin: https://www.healthaidb.com/software/trizetto.json

Company Name

Cognizant

Product URL

https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto

Company URL

https://www.cognizant.com

Categories

Summary

TriZetto is Cognizant's portfolio of healthcare administration software for payers and provider revenue-cycle operations, offering core administration, claims processing, care management and clearinghouse services.

Description

TriZetto (a Cognizant product portfolio) provides enterprise-grade health plan and provider administration software — including Facets and QNXT core administration, claims adjudication, clearinghouse, care and utilization management, provider data/reimbursement tools, analytics and managed/cloud services — designed to automate billing, enrollment, eligibility, claims processing and payment workflows for commercial, Medicare and Medicaid lines of business.

Api Available

yes

Certifications

Company Founding

1997

Company Offices

Compliance

Customers

Data Residency

Cloud region options including US; regional hosting options vary by deployment and customer requirements

Data Standards

Deployment Model

Features

Id

P1681

Integration Partners

Integrations

Languages Supported

Last Updated

2025-09-07

License

commercial, proprietary

Links

Market Segment

Optional Modules

Os Platforms

Pricing Details

Contact vendor for pricing, deployment and licensing tiers; enterprise sales and managed-service quotes available.

Pricing Model

enterprise_quote

Privacy Features

Ratings

Regions Available

Release Year

1997

Security Features

Specialties

Support Channels

System Requirements

Cloud-hosted; on-prem components support Windows/Linux servers and common RDBMS (varies by product, typically Oracle/enterprise DBs)

Target Users

Training Options

Type

product

User Reviews

Version

1.0

Canonical JSON

{
  "company_name": "Cognizant",
  "company_url": "https://www.cognizant.com",
  "company_offices": [
    "United States",
    "India",
    "United Kingdom",
    "Canada",
    "Australia",
    "Ireland",
    "Germany",
    "Philippines"
  ],
  "company_founding": "1997",
  "product_url": "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto",
  "categories": [
    "administrative",
    "payer administration",
    "core administration",
    "interoperability",
    "care management",
    "provider-facing",
    "quality management",
    "revenue cycle management"
  ],
  "market_segment": [
    "enterprise"
  ],
  "links": [
    "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto",
    "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto/core-administration/qnxt",
    "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto/core-administration/facets",
    "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto/resource-center",
    "https://www.cognizant.com/en_us/trizetto/documents/trizetto-healthcare-products-qnxt-brochure.pdf",
    "https://news.cognizant.com/2014-09-15-Cognizant-to-Acquire-TriZetto-Creating-a-Fully-Integrated-Healthcare-Technology-and-Operations-Leader",
    "https://www.g2.com/products/trizetto-facets/reviews",
    "https://www.g2.com/products/trizetto-qnxt/reviews",
    "https://trizettoprovider.com",
    "https://www.cognizant.com/us/en/industries/healthcare-technology-solutions/trizetto/claimsphere-suite"
  ],
  "summary": "TriZetto is Cognizant's portfolio of healthcare administration software for payers and provider revenue-cycle operations, offering core administration, claims processing, care management and clearinghouse services.",
  "description": "TriZetto (a Cognizant product portfolio) provides enterprise-grade health plan and provider administration software — including Facets and QNXT core administration, claims adjudication, clearinghouse, care and utilization management, provider data/reimbursement tools, analytics and managed/cloud services — designed to automate billing, enrollment, eligibility, claims processing and payment workflows for commercial, Medicare and Medicaid lines of business.",
  "target_users": [
    "health plan administrators",
    "payers",
    "provider revenue cycle teams",
    "billing and claims specialists",
    "care managers",
    "IT/operations teams",
    "healthcare administrators"
  ],
  "specialties": [
    "health plan administration",
    "claims processing",
    "revenue cycle management",
    "care management",
    "utilization management",
    "provider enrollment/credentialing",
    "provider reimbursement"
  ],
  "regions_available": [
    "United States",
    "Canada"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "enterprise_quote",
  "pricing_details": "Contact vendor for pricing, deployment and licensing tiers; enterprise sales and managed-service quotes available.",
  "license": "commercial, proprietary",
  "features": [
    "Core administration (Facets, QNXT)",
    "Interoperability / TriZetto Unify",
    "Member and provider portals (EngageMember, EngageProvider)",
    "Care management (CareAdvance, CareAdvance Provider)",
    "Claims processing and adjudication",
    "Encounter data management and submission",
    "Enrollment administration and workflow",
    "Risk score management",
    "Prior authorization automation (FHIR-based)",
    "Cost estimation and price transparency",
    "Provider reimbursement (NetworX Pricer/Modeler)",
    "Clearinghouse and trading partner services",
    "Quality management and analytics (ClaimSphere)",
    "Touchless Authorization Processing (TTAP)",
    "Financial reconciliation",
    "Real-time data publishing and web services",
    "Patient/member engagement tools",
    "Reporting and regulatory submission support"
  ],
  "integrations": [
    "Clearinghouses / trading partner networks",
    "Payer core systems (Facets, QNXT)",
    "Provider EHR/clinical systems via interoperability layer",
    "Provider networks / provider directories",
    "Claims and billing systems",
    "Payment and reconciliation systems"
  ],
  "deployment_model": [
    "cloud/SaaS",
    "on_prem",
    "hybrid"
  ],
  "os_platforms": [
    "Web",
    "Windows",
    "Linux"
  ],
  "optional_modules": [
    "Facets Open Access / real-time data publishing",
    "Cost Estimate Connector",
    "Touchless Authorization Processing (TTAP)",
    "ClaimSphere analytics modules",
    "TriZetto Elements modules",
    "NetworX payment bundling administration",
    "Enrollment Administration Manager (EAM)",
    "Encounter Data Manager (EDM)"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "X12 (HIPAA transactions)",
    "NCPDP",
    "ICD-10",
    "SNOMED"
  ],
  "api_available": "yes",
  "system_requirements": "Cloud-hosted; on-prem components support Windows/Linux servers and common RDBMS (varies by product, typically Oracle/enterprise DBs)",
  "compliance": [
    "HIPAA",
    "HITECH"
  ],
  "certifications": [],
  "security_features": [
    "encryption (in transit and at rest)",
    "role-based access control (RBAC)",
    "SSO/SAML support",
    "audit logging",
    "multi-factor authentication (MFA)"
  ],
  "privacy_features": [
    "Business Associate Agreement (BAA) available",
    "consent management support",
    "data de-identification/anonymization options"
  ],
  "data_residency": "Cloud region options including US; regional hosting options vary by deployment and customer requirements",
  "customers": [
    "Kern Health",
    "Priority Health",
    "Signature Performance",
    "American Pathology Partners",
    "Bucksport Regional Health Center",
    "Health Plan of San Joaquin",
    "MedPartners",
    "Not-for-profit regional health plan (case study)",
    "Various Blues Plans (mentioned in product announcements)"
  ],
  "user_reviews": [
    "Been with Trizetto for years. I generally don't have an issue but since they changed to the new credentialing company it's been not so great.",
    "We have been using Trizetto's Gateway EDI for years and I'm happy with it.",
    "I don't have direct experience with TriZetto, but it's commonly recommended for billing integrations.",
    "I find Trizetto is not user friendly. The ICD-10 codes should carry over when billing the same patient and it's tedious to continue to put them.",
    "We use trizetto (ophthalmology practice) and have been with them for roughly 7 years now? ... we rarely have problems.",
    "Costs can increase as you add more providers because pricing is based on number of providers."
  ],
  "ratings": [
    "G2: TriZetto Facets - Quality of Support 8.5/10 (G2 product comparison listings)",
    "G2: TriZetto QNXT - average rating ~4.3/5 (G2 user reviews summary)",
    "ITQlick: TriZetto Facets - 4.3/5 (product overview)",
    "KLAS: Cognizant TriZetto Provider Solutions Clearinghouse - listed reviews (KLAS research presence)"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "1997",
  "integration_partners": [
    "Microsoft Azure",
    "Amazon Web Services (AWS)",
    "Gateway EDI (acquired by TriZetto previously)",
    "InterScripts",
    "Alivia Analytics",
    "Datadog"
  ],
  "id": "P1681",
  "slug": "trizetto",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-09-07",
  "links_json": {
    "self": "https://www.healthaidb.com/software/trizetto.json"
  }
}