Improve your clean

claim percentage

See TPS in Action.

Rejection and Denial Prevention

AI powered denial defense. Fitting in with a practice’s claim management workflow, our claim editing solution combines claim scrubbing for coding type denials, a check for eligibility coverage and our machine learning-based denial prediction solution to prevent claim denials before submitting to the payer.

With our solutions, you can:

  • Implement cutting edge technology to improve accuracy and minimize errors
  • Identify potential denials with automated eligibility, coding and machine learning edits to secure proper reimbursement
  • Reduce administrative costs and back-end work through proactive intervention
  • Increase speed-to-payment by submitting cleaner claims.
Claim errors
may drop to

1%

or less*

*Based on client data. Results may vary.

We have been with TriZetto Provider Solutions for well over 10 years. They are a life saver for me because they make my job easier.   

– Maria Colon, Mobile Life Support Services

Highlighted Resources

 

Product Sheet Predictive Claim Outcomes

Leveraging an advanced machine learning model to provide deeper insights into potential denials.

CaseStudy_RCM_StAnthony-1

See how clearinghouse services from TPS scaled with this organization as they experienced 400% growth.

ProductSheet_Advanced Reimbursement Manager Pro_24

Streamline the discovery and recovery of denied and underpaid claims by automating manual, tedious processes.

ProductSheet_ActionEdits_23

An integrated solution that provides real-time edits and improves clean claim rates.