Who this is for: All Barti users setting up or evaluating TriZetto services.
Supported TriZetto services
Electronic Claims
Submit primary and secondary claims electronically to payers through TriZetto. Includes Electronic Remittance Advice (ERA) — electronic notifications of claim payments — and Online Claim Correction to correct claims directly in TriZetto without creating a new submission.
Eligibility Check (PRE)
Verify whether a patient is actively covered under their insurance plan before the visit. When completing the TriZetto sign-up form, select PRE and Eligibility under EDI services. If you're unsure of your estimated monthly volume, provide a rough estimate — you can calculate it by multiplying your average daily patient count by 30.
Paper Claims
For payers that don't accept electronic submission, TriZetto handles the submission of paper claims on your behalf. In Barti, use the Finalize Claim button to enter the manual workflow and print a CMS 1500 form.
Denials Workflow Pro
A TriZetto service to manage and streamline the workflow for denied claims.
Claims Status Inquiry (CSI)
Check the status of submitted claims directly within TriZetto.
Workers' Compensation Claims
Submit workers' compensation claims electronically through TriZetto if your office handles them.
Auto Appeals
Correct and appeal claims directly within TriZetto.
What's not handled through TriZetto
VSP claims — must be submitted through the VSP portal directly.
Medically necessary contact lens (MNCL) orders — completed through payer portals, not Barti or TriZetto.
Materials billing — Barti RCM does not handle materials claims.
Estimating your monthly claims volume
To estimate your monthly claims volume for the TriZetto sign-up form: multiply the number of patients you see per day by 30. If you're unsure, provide a rough estimate — it can be updated later.