Three ways to work
Whether it's in your system, along with your system, or in ours, we help you bill cleanly and correctly.
In your system
Trizub works behind the scenes in your EHR. It checks registration, eligibility, and authorization messages as they flow, and every fix is proven by the next message.
Along with your system
A sidekick panel next to your EHR for patient access QA, claim corrections, and denials and appeals. Your EHR stays the system of record.
In ours
The full Trizub RCM platform: eligibility, prior authorization, claims, payments, denials, appeals, and reporting in one place.
Behind all three, multiple rule engines cover each stage of the revenue cycle and are orchestrated to work as one, so you can start where you are.
- 6k+payer connections
- 15+years of experience
Built on the rails healthcare runs on
We move healthcare data through EDI and HL7 so eligibility, claims, payments, and clinical messages flow without rekeying. Reach 6,000+ payer connections across medical, dental, and vision through multiple clearinghouse networks, alongside the clearinghouse you already use.
EDI transactions we automate
270/271
Eligibility and benefits
Coverage, benefits, and coordination of benefits checked before the visit, single or in batches.
837P / 837I / 837D
Claims
Professional, institutional, and dental claims scrubbed and submitted, with 277CA acknowledgments tracked.
276/277
Claim status
Automated follow up that catches pended and stalled claims without anyone logging in to a portal.
835
Remittance
Payment posting, underpayment review, and denial code trending straight from the remit.
EFT
Electronic funds transfer
Payments matched to remits so cash reconciliation stops being a spreadsheet job.
275
Claim attachments
Medical records and documentation sent electronically, with portal automation where a payer has no EDI option.
HL7 and clinical data
- ADT: registrations, admits, and demographic updates
- ORM / ORU: orders and results
- SIU: scheduling
- DFT: charges into billing
- FHIR APIs and EHR practice management connections
- Interface engine connections such as Mirth
How a payer gets connected
Send your payer list
Payer names and IDs from your billing system.
We map every payer
Which transactions are available, on which network, and what needs enrollment.
We handle the setup
Enrollment forms, portal access, and go-live, payer by payer.
The Trizub RCM platform
Trizub RCM catches problems at the source, before they turn into denials, rework, and weeks of chasing. It's hosted in a HIPAA-compliant environment with a BAA in place.
Trizub runs multiple rule engines, each built for its stage of the revenue cycle, from patient access and claim scrubbing to denials, payments, and reconciliation. They are orchestrated to work as one, so nothing falls between the stages.
Front end
Patient registration, eligibility, coverage discovery, financial clearance, prior authorizations
Middle
Encounter to claim, charges, coding optimization, claims and EDI batches, EDI analytics
Back end
Payments and cash reconciliation, underpayment detection, contracts, denials, AI appeals, collections, statements, payment plans
Data and integrations
HL7 inbox, interface engine and EHR connections, records retrieval, automation monitoring
Insights
Revenue intelligence, payer and team performance, reporting, compliance
Productivity and performance
Team productivity, worklist progress, revenue cycle KPIs, and performance monitoring
Mobile-friendly for on-the-go RCM monitoring. Keep an eye on team productivity, worklist progress, and revenue cycle performance from your phone.
Healthcare and Regulated Industries
Revenue Cycle Management
Years inside a major health system's revenue cycle, followed by healthcare AI product leadership. End to end coverage from eligibility and authorizations through claims, denials, appeals, and patient balances, for dental, physician, and facility workflows.
Clinical Workflows
Clinical process optimization and operations support. EHR integration, HL7 data flows, document processing, and PHI-safe AI pipelines connect patient information and support the handoffs between teams.
AI in Healthcare and Regulated Industries
Production platforms for federally regulated healthcare disputes and filings. Automated federal portal filing, AI brief generation, deadline management, payer correspondence automation, claim document OCR, dual-database PHI isolation.
Revenue cycle sub-flows we build
Workflows we build in a revenue cycle engagement.
Healthcare Product Offerings
Ready-to-deploy workflows for practices, dental groups, labs, and health systems. Whether it's in your system, along with your system, or in ours, we help you bill cleanly and correctly.
Eligibility Agent
Trizub agent
Eligibility and benefits verification
- What we do
- We check coverage, benefits, and coordination of benefits through 270/271 and payer portals before the visit.
- Why we're different
- Checks run the moment registration data arrives, and every fix is confirmed by the next response.
- The value
- Fewer front-end denials and fewer surprise patient balances.
Authorization Agent
Trizub agent
Prior authorization automation
- What we do
- We flag which services need authorization, gather the clinical details, and track each request to a decision.
- Why we're different
- Payer rules and the order are checked together, so missing authorizations are caught before the service.
- The value
- Less staff time on hold and fewer write-offs for missing authorizations.
Claims Agent
Trizub agent
Claim submission and status tracking
- What we do
- We scrub every claim against the order and the authorization, send the 837, and follow it with 276/277 status.
- Why we're different
- Corrections go straight to the right person instead of a shared work queue.
- The value
- Cleaner first-pass claims and faster payment.
Appeals Agent
Trizub agent
Denial management and appeals
- What we do
- We sort denials by root cause and draft appeals with the supporting records attached.
- Why we're different
- Staff review before anything goes out, and each root cause is fixed upstream so it stops repeating.
- The value
- More recovered revenue and fewer repeat denials.
Payments Agent
Trizub agent
Remittance and payment posting
- What we do
- We read 835 remits, match them to deposits, and post payments and adjustments.
- Why we're different
- Shortfalls are flagged against your contracted rates, not just posted.
- The value
- Faster reconciliation and underpayments you can actually chase.
A/R Agent
Trizub agent
Patient balance and A/R workflows
- What we do
- We prioritize A/R and patient balances by dollar value and likelihood to collect.
- Why we're different
- Worklists are built from the data, so staff work the accounts that matter first.
- The value
- Lower days in A/R and fewer accounts aging out.
Connectivity Agent
Trizub agent
Payer and clearinghouse connectivity
- What we do
- We set up and maintain EDI connections to payers and clearinghouses for every transaction type.
- Why we're different
- One team owns enrollment, testing, and monitoring end to end.
- The value
- Fewer rejected files and no gaps when payers change.
Insights Agent
Trizub agent
Revenue cycle reporting and analytics
- What we do
- We put days in A/R, clean claim rate, denial rate, net collection rate, and cash on one screen.
- Why we're different
- Every number links to the work behind it, one click away.
- The value
- Leaders see where cash is stuck and act on it the same day.
Start with a 30-minute call.
Tell us where your revenue cycle hurts. If there is money to recover, the audit is free.