Trizetto

A Cognizant Company.

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Overview

Trizetto, a part of Cognizant, is a major provider of technology solutions for the healthcare payer market. Their platforms (like Facets and QNXT) are the core systems that health plans use to manage members, process claims, and handle benefits. While they serve payers, their systems are the source of truth for the eligibility data that provider-facing tools query.

✨ Key Features

  • Core Administrative Processing Systems (CAPS)
  • Claims Processing & Adjudication
  • Benefit Plan Configuration
  • Member Enrollment and Management
  • Provider Network Management

🎯 Key Differentiators

  • Deep expertise and long history in the payer market
  • Comprehensive, end-to-end solutions for health plan administration
  • Large, established base of payer clients

Unique Value: Provides the robust, scalable, and compliant core systems that health plans need to operate their business.

🎯 Use Cases (3)

Running the core operations of a health insurance plan Processing millions of medical claims Managing complex benefit structures and provider contracts

✅ Best For

  • Core platform for health plan administration
  • High-volume claims adjudication

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Healthcare providers looking for a tool to check patient eligibility
  • Small medical practices

🏆 Alternatives

HealthEdge Epic (Tapestry) In-house legacy systems

Offers a more comprehensive and integrated suite of solutions than smaller point-solution vendors in the payer space.

💻 Platforms

Desktop Web

🔌 Integrations

Various payer and provider systems EDI Gateways

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Enterprise tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ GDPR ✓ ISO 27001 ✓ SSO ✓ SOC 1 ✓ SOC 2 ✓ HITRUST ✓ ISO 27001

💰 Pricing

Contact for pricing
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