Checking remits via TriZetto allows healthcare providers, including optometrists, to efficiently manage and track their insurance claim payments. Here are some key reasons why someone would want to check remits using TriZetto:
Payment Tracking – Ensures that payments from insurance companies have been received and correctly posted.
Denial Management – Identifies claim denials and provides reasons for rejections, allowing for timely appeals and corrections.
Reconciliation – Helps match payments to specific claims, reducing errors and improving financial accuracy.
Efficiency – Automates the process of reviewing remittance advice, saving time compared to manual processing.
Cash Flow Management – Provides insights into expected payments and outstanding amounts, aiding in financial planning.
Claim Status Verification – Confirms if claims were paid, underpaid, or denied, allowing for quick resolution.
Compliance and Auditing – Maintains records for audits and compliance with billing regulations.
By using TriZetto, providers can streamline their revenue cycle management and reduce administrative burdens, ensuring they receive proper reimbursement for services rendered.
To do this, please take the following steps:
Step 1: Navigate to https://mytools.gatewayedi.com/ and log in.
Step 2: Click Manage Payments
Step 3: Click "View Insurance Payments (Remittances)"
Step 4: Select the "Month to Date" Option
Step 5: Click the "Show Archived (Previously Downloaded) Remittances" field
Step 6: Click "Search"
Troubleshooting Common Issues
Missing Remit Payments: Ensure that the correct date range and filters are applied.
Unposted Payments: Check if manual posting is required.
Error Messages: Verify that your search criteria are accurate and retry.
Additional Tips
Our team will regularly download and archive remittance files for compliance and reconciliation. When you are looking at this, you will need to check archived remits as well.
Review payment patterns to identify recurring adjustment codes or trends in denied claims.
This guide provides a structured approach to checking remit payments in TriZetto. Let our team know if you need further clarification or additional details on specific steps!