TriZetto Provider Solutions Offers Innovative Approach for Managing the Financial Impact of ICD-10

DENVER--()--TriZetto Corporation today announced a new solution to help physicians manage the financial impact of the transition to ICD-10. Delivered by TriZetto’s Provider Solutions business unit, the solution is called eobResolve®, and it helps providers collect appropriate payments caused by erroneous claim denials and underpayments due to coding errors during the hectic ICD-10 transition.

According to the Workgroup for Electronic Data Interchange1, claim denial rates are projected to rise anywhere from 100 to 200 percent after the healthcare industry transitions to ICD-10 coding. Meanwhile, according to results from a recent nationwide survey2, more than 70 percent of provider respondents had made no plans to prepare for increased claim denials as a result of ICD-10.

The eobResolve solution helps providers identify and organize mistakenly denied and underpaid claims, as well as provide a detailed explanation for each denial or underpayment. The solution streamlines processes needed to resolve payment errors and avoid similar future mistakes, and provides management reporting that categorizes and quantifies the financial impact of coding issues.

“Our industry continues to experience enormous change, requiring providers to have more access to helpful business intelligence,” said Lori Logan, president (interim), TriZetto Provider Solutions. “eobResolve delivers information providers need to help ensure proper payment, which is critical as we transition to ICD-10--one of the biggest challenges for the healthcare industry in our lifetime.”

“It is highly likely that with the industry transition to ICD-10, claim denials due to coding errors are going to rise. How providers prepare for this increase will greatly impact their financial success in the post-ICD-10 world,” said Jeffrey Rose, MD, chief medical information officer for TriZetto.

To help all providers navigate ICD-10, TriZetto offers helpful tips and advice through its provider resource center at

About TriZetto Corporation

TriZetto Corporation provides world-class information technology and service solutions that help payers and providers work more efficiently and collaborate to deliver better health. TriZetto solutions touch over half the U.S. insured population and reach more than 200,000 care providers. TriZetto helps healthcare organizations enhance administrative efficiency; improve the cost, quality and delivery of care; address compliance; and compete to win in an emerging retail market. Payer solutions include benefits administration, care management, network management and portal platforms, as well as consulting, application management and business management services. Provider solutions include real-time eligibility assurance, claims editing, revenue cycle management technology and services that help providers get paid quickly and accurately. For more information, visit

About TriZetto Provider Solutions

TriZetto Provider Solutions serves more than 200,000 providers across the country, equipping physicians, hospitals and health systems with tools and information they need to help simplify business processes and ensure accurate payments are received quickly. TriZetto Provider Solutions is built on the combined technology and experience of Gateway EDI, NHXS, and ClaimLogic, and plays an important role in driving greater collaboration between providers and payers.

1 Workgroup for Electronic Data Interchange, “ICD-10 Critical Metrics.” October 2012.

2 TriZetto Provider Solutions Client Survey, “How Is Your Practice Planning to Prepare for Increased Denials Due to ICD-10?” December 2013.


Davida Dinerman, 781-684-0770

Release Summary

TriZetto Corporation today announced a new solution, called eobResolve®, to help physicians manage the financial impact of the transition to ICD-10.


Davida Dinerman, 781-684-0770