# TriZetto QNXT Reviews **Vendor:** Cognizant **Category:** [Core Administrative Processing Systems Software](https://www.g2.com/categories/healthcare-payers-core-administrative-processing-solutions) **Average Rating:** 4.3/5.0 **Total Reviews:** 13 ## About TriZetto QNXT TriZetto offers consulting, IT, and business process solutions to streamline the deployment and adoption of technologies and improve operations for payers and providers in the health care industry. TriZetto solutions are designed to improve efficiency, accuracy, compliance, and results throughout the health care system. ## TriZetto QNXT Reviews ### 1. US helathcare care web based total payer solution **Rating:** 4.5/5.0 stars **Reviewed by:** Omkar G. | Lead l Software testing, Enterprise (> 1000 emp.) **Reviewed Date:** October 31, 2023 **What do you like best about TriZetto QNXT?** Best thing about QNXT is it is getting upgraded as per new trends and adopt new things easily. It is secured and all things like starting from enrolling a member, provider till the last step of claim settlement and be done within a single application. **What do you dislike about TriZetto QNXT?** Many times user faces the latency while surfing through application in the pick time. Also the audit or history do not store detail records. Only the last changes can be seen, it is expected that whenever there is any changes to the record it should show which all fields were change each time. **What problems is TriZetto QNXT solving and how is that benefiting you?** QNXT is one stop solution to payers in the US helathcare industry. It helps in enrolling the members and manage the claim revenue cycle. It has integration with many other third-party tools to support above objectives. ### 2. Modern interface with sleek look **Rating:** 4.0/5.0 stars **Reviewed by:** Verified User in Hospital & Health Care | Mid-Market (51-1000 emp.) **Reviewed Date:** October 17, 2020 **What do you like best about TriZetto QNXT?** Able to perform different functions in the same program **What do you dislike about TriZetto QNXT?** Text can be refined, i.e., better capitalization, etc. **What problems is TriZetto QNXT solving and how is that benefiting you?** Streamlining information systems ### 3. A Data Analyst's and Developer's Dream **Rating:** 4.0/5.0 stars **Reviewed by:** Bruce W. | Software Developer, Mid-Market (51-1000 emp.) **Reviewed Date:** November 20, 2020 **What do you like best about TriZetto QNXT?** For EDI reporting and tracking, the QNXT database and the way it's structured makes it easy to effectively conduct research and provide resolutions for client issues with custom reporting. Reports generated from within the QNXT application. As well, the backend data can be used in conjunction with error logs which provides data downstream for the Executive Dashboard by developing a new MS Access Benefit Load and Tracking Database. As well, a great platform which makes it a straightforward process to effectively troubleshoot incidents errors in 837 and 835. The QNXT database integrates nicely when you write and run SQL queries on Oracle or SQL Server database table joins with QNXT. **What do you dislike about TriZetto QNXT?** QNXT is great at pricing claims, administering members, and managing billing. The issues are with having to adapt to new requirements in processing. For instance, it’s difficult to do a member lookup and replace before processing. QNXT intakes 837 claims files and EDI 834 enrollment files using Microsoft BizTalk Server. The files are translated from EDI to XML within BizTalk’s native EDI parsing pipeline component deployed as part of QNXT’s ‘QNXT Connect’ BizTalk Application. QNXT receives the XML where it is carried through it’s modules. However, it is often the case that custom logic is necessary to ensure the success of the message within QNXT. This can be due to: Enrichments or lookups necessary to the file, such as the previously mentioned need for a member lookup and replacement Conditional routing based on success or failure of the file Pre-validation to prevent a single failed record from causing failure of the entire transaction set Typically there are two ways to allow for the application of custom logic within a QNXT implementation – applications deployed in BizTalk, or custom agents deployed in QNXT. Developing BizTalk applications, while very robust and flexible, require an advanced skill set to employ effectively. Not only does a developer have to know BizTalk, but also have a high degree of knowledge of XML in order to properly ‘work’ with the EDI. BizTalk does not supply out of the box APIs to ease the EDI development burden when working with healthcare data. Looking back at the scenario of member lookups, a BizTalk application would have to be created that would perform member lookups and replacements. This however, would require knowledge of XPath navigation of the XML schemas used by BizTalk to update the member fields. QNXT agents can be developed in C# .NET, and easily deployed using a QNXT provided deployment wizard. These agents can be positioned to execute prior to processing (Pre Agent) or post-processing (Post Agent). An executing agent has access to an XML representation of the EDI data received by QNXT, whether claims, enrollments or other data sets. Using an agent negates the need for specialized BizTalk knowledge, however presents several limitations that have to be overcome: XML: EDI is presented as XML within another XML wrapper containing file specific metadata injected by many layers of nesting and knowledge of XPath may present difficulty in developing an agent. Testing: Testing custom pre and post agents requires either attaching a debugger to QNXT or careful interpretation of log entries within the QNXT process log browser. Tracking: QNXT only surfaces the start and end of a custom agent’s execution, with only basic record counts and a success/failure logged. Maintenance: There is a wizard provided to deploy agents, however custom built agents may need frequent updates to ensure compatibility as new QNXT versions are deployed. QNXT Pre and Post agents' custom steps do not have access to the full X12 EDI message and a robust EDI parser, validator, splitter among its API tools. This is helpful in allowing seamless editing and resubmission of problem claims or enrollments. Preprocessing EDI files within an existing TriZetto QNXT implementation remains a challenge in some cases. **What problems is TriZetto QNXT solving and how is that benefiting you?** Custom coding is a development process. There are two types of custom code development: supported and unsupported. Supported and unsupported code are both deployed to the QNXT Custom Database. Custom coding is not used to enhance the QNXT application itself. Put another way, the QNXT application is not something that can be modified under the QNXT license and support agreement. Custom coding is used to extend QNXT, or to allow for integration with QNXT. These customizations are applied outside of QNXT itself. Some common examples of custom code are extracts and interfaces to other line of business applications like Finance/Accounting, CRM and Case Management. QNXT also does a good job of allowing for several points of integration. The ones I've used are: the QNXT SDK and the QNXT Custom Database. The purpose of the QNXT Custom Database is to provide a layer of abstraction over the out of the box QNXT database called Plan Data. Changes that ordinarily could be applied to Plan Data, by way of new stored procedures, views, and other database objects, are applied to this Custom database instead. This way the Plan Data database remains unchanged, with all customer customizations are one place, the Custom Database. The QNXT Custom Database hosts all custom database code, as well as any data that supports these customizations. There is also a QNXT Stage Database. This database is also used for customization. The difference is the Stage database is permanent in structure, but temporary in storage. It is a temp database. If you have an extract for example, that requires some pre-processing or post-processing, you can temporarily host your interim-state data in Stage. ### 4. Great platform and user experience **Rating:** 4.5/5.0 stars **Reviewed by:** Andy H. | Senior Actuarial Analyst, Insurance, Small-Business (50 or fewer emp.) **Reviewed Date:** October 13, 2020 **What do you like best about TriZetto QNXT?** I really like TriZetto QNXT‘s front end and user experience. It is very integrated with my other softwares and pairs nicely with our workflows. **What do you dislike about TriZetto QNXT?** I dislike how TriZetto QNXT has limited features and mobility. I would like to see that built out a little more. **Recommendations to others considering TriZetto QNXT:** I would highly recommend TriZetto QNXT for their deep front end user experience and analytics capabilities. **What problems is TriZetto QNXT solving and how is that benefiting you?** Our organization is solving many logistical and functional problems with TriZetto QNXT. We have leveraged the software to realize efficiency benefits, particularly in our supply chain analytics. ### 5. An all in one solution **Rating:** 4.0/5.0 stars **Reviewed by:** Luis A. | Compliance Analyst, Enterprise (> 1000 emp.) **Reviewed Date:** October 16, 2020 **What do you like best about TriZetto QNXT?** QNXT is an all in one solution for the healthcare insurance industry. All your functions in one big and responsive data base. **What do you dislike about TriZetto QNXT?** Better reporting services from QNXT, an integration to other reporting tools. **What problems is TriZetto QNXT solving and how is that benefiting you?** QNXT can integrate multiple solutions into one simple main function, processing claims. ### 6. QNXT APPRAISAL **Rating:** 4.0/5.0 stars **Reviewed by:** JULIO B. | Mid-Market (51-1000 emp.) **Reviewed Date:** November 04, 2020 **What do you like best about TriZetto QNXT?** Organic interface, seamless movement between functions. **What do you dislike about TriZetto QNXT?** That backdoor functions don't apply to certain tools within system. **What problems is TriZetto QNXT solving and how is that benefiting you?** Medicare, Medicaid PBM & CMS FUNCTIONS. ### 7. QNXT is a Wonderful product **Rating:** 4.0/5.0 stars **Reviewed by:** Verified User in Information Technology and Services | Enterprise (> 1000 emp.) **Reviewed Date:** October 25, 2020 **What do you like best about TriZetto QNXT?** QNXT can be easily integrated with different solutions. **What do you dislike about TriZetto QNXT?** I am not very much sure what I do not like about QNXT **Recommendations to others considering TriZetto QNXT:** I will recommend QNXT **What problems is TriZetto QNXT solving and how is that benefiting you?** Dealing with different module of healthcare individually, like providers, members, claims etc. And QNXT can be integrated with several other product like Biztalk, also It’s customizable. ### 8. It’s very easy to operate while processing the claims. **Rating:** 5.0/5.0 stars **Reviewed by:** Verified User in Hospital & Health Care | Mid-Market (51-1000 emp.) **Reviewed Date:** October 22, 2020 **What do you like best about TriZetto QNXT?** Qnxt application delivers the flexibility and functionality necessary to improve performance and increase efficiency. **What do you dislike about TriZetto QNXT?** Qnxt has limited features and mobility, I would like to see that built out a little more. **Recommendations to others considering TriZetto QNXT:** Na **What problems is TriZetto QNXT solving and how is that benefiting you?** Core administration system is end to end claims. We use required cookies to enable core site functionality. ### 9. Trizetto Clearing House **Rating:** 4.5/5.0 stars **Reviewed by:** Marina B. | Chiropractic Assistant, Medical Practice, Small-Business (50 or fewer emp.) **Reviewed Date:** October 17, 2019 **What do you like best about TriZetto QNXT?** It sends back reports of errors and everything else is easy to track **What do you dislike about TriZetto QNXT?** I wish I would get email notification about denials **What problems is TriZetto QNXT solving and how is that benefiting you?** easy Electronic Billing ### 10. Using Qnxt operating system **Rating:** 4.5/5.0 stars **Reviewed by:** Verified User in Banking | Enterprise (> 1000 emp.) **Reviewed Date:** September 25, 2019 **What do you like best about TriZetto QNXT?** It is user friendly. It can be interfaced wit other operating systems effortlessly. **What do you dislike about TriZetto QNXT?** Limited functionality is a down fall for us. **Recommendations to others considering TriZetto QNXT:** This system has it good and s few bad qualities. **What problems is TriZetto QNXT solving and how is that benefiting you?** We are able to meet are clients individual needs, and process claims in alignment with the providers agreement. ### 11. Makes collecting client payments and printing statements so much easier! **Rating:** 4.5/5.0 stars **Reviewed by:** Verified User in Mental Health Care | Mid-Market (51-1000 emp.) **Reviewed Date:** December 18, 2018 **What do you like best about TriZetto QNXT?** Trizetto allows our medium sized mental health agency to collect client credit card payments in office, over the phone, or online. This has helped exponentially when it comes to collecting payments for services. It has helped us collect a higher percentage of payments overall, collect them more quickly, and decreased the time that our billing team has to spend following up with clients with outstanding balances. It also gives us functionality to print and mail statements or send them out electronically when we do need to follow up with clients for outstanding balances. **What do you dislike about TriZetto QNXT?** Trizetto services do cost quite a bit of money. Next to our electronic health records system, it is our second largest costs (besides employees' salaries). That being said, the timeliness of collecting payments means that we overall are able to manage our Account and Revenue cycle much more efficiently and allows for more accurate projections or our agency's success and services completed. **Recommendations to others considering TriZetto QNXT:** If you have a client/customer base that needs a variety of efficient payment options (i.e. online, paper/mail, over the phone, and in office) Trizetto can meet all of these needs. It is costly, but worth implementing if you have a large enough customer base. **What problems is TriZetto QNXT solving and how is that benefiting you?** Trizetto allows to collect client credit card payments in office, over the phone, or online which has led to more timely and completed collection of payments for services. Its ability to print and send client statements (and track completion of payments) has led to decreased time that our billing team has to spend following up with clients with outstanding balances. The ease of payment options has improved client relationships since we make it easier for them to access and make payments towards their balances in any way they can (online, over the phone, via mail, or in the office). ### 12. Trizetto, difficult to customize **Rating:** 3.0/5.0 stars **Reviewed by:** Verified User in Insurance | Enterprise (> 1000 emp.) **Reviewed Date:** November 28, 2018 **What do you like best about TriZetto QNXT?** Generally system is easy to read and fields are descriptive and easy to navigate. **What do you dislike about TriZetto QNXT?** The Facets product we use is not very user friendly and does not properly manage many functions necessary for our business purposes. Customization is expensive and time consuming. **What problems is TriZetto QNXT solving and how is that benefiting you?** Aligned processing systems with other Blues plans. ### 13. Facets, Cadillac of claims processing systems **Rating:** 5.0/5.0 stars **Reviewed by:** Verified User in Health, Wellness and Fitness | Enterprise (> 1000 emp.) **Reviewed Date:** November 21, 2018 **What do you like best about TriZetto QNXT?** The versatility of the product from Utilization management to provider management is excellent. **What do you dislike about TriZetto QNXT?** The complexity for installation and configuration **What problems is TriZetto QNXT solving and how is that benefiting you?** Claims processing - [View TriZetto QNXT pricing details and edition comparison](https://www.g2.com/products/trizetto-qnxt/reviews?section=pricing&secure%5Bexpires_at%5D=2026-06-04+09%3A56%3A40+-0500&secure%5Bsession_id%5D=c4e777f3-48b8-41f9-a220-83b9bc53de8b&secure%5Btoken%5D=42b483eb0a1160764ba4452672aa4a4d0ecbfcc85aba732273339b9709f79422&format=llm_user) ## TriZetto QNXT Features **Workflow Automation** - Contract Management - Health Care Credentialing - Workflow Management - Health Care Credentialing - Database Management - Health Care Credentialing - User Authorization - Health Care Credentialing **Administration** - Process Automation - CAPS - Claims Processing - CAPS - Legacy Support - CAPS **Clinical** - Compliance - Revenue Cycle Management (RCM) - Software Integrations - Revenue Cycle Management (RCM) - Task Automation - Revenue Cycle Management (RCM) **Efficiency ** - Claims Data Automation - Healthcare Claims Management - Electronic Submissions - Healthcare Claims Management - Clearinghouse Integration - Healthcare Claims Management - Claims Process Workflow - Healthcare Claims Management **Compliance** - Facility Management - Health Care Credentialing - Facility Compliance Management - Health Care Credentialing - Industry Compliance Management - Health Care Credentialing **Operations** - Compliance - CAPS - Care Innovation - CAPS - Interoperability - CAPS - Cloud Hosted - CAPS **Financial** - Billing Automation - Revenue Cycle Management (RCM) - Clearinghouse Integration - Revenue Cycle Management (RCM) - Claims Management - Revenue Cycle Management (RCM) **Accuracy** - Claims Resubmission - Healthcare Claims Management - Patient Data Security - Healthcare Claims Management - Claims Scrubbing - Healthcare Claims Management **Verification** - Provider Database Collection - Health Care Credentialing - Privileging - Health Care Credentialing - Commitee Review - Health Care Credentialing **Document Management** - Credentialing e-Documentation - Health Care Credentialing - Document Database - Health Care Credentialing - Information Audit - Health Care Credentialing ## Top TriZetto QNXT Alternatives - [Essentials](https://www.g2.com/products/essentials/reviews) - 4.0/5.0 (42 reviews) - [Waystar](https://www.g2.com/products/waystar/reviews) - 4.4/5.0 (116 reviews) - [Tebra (previously Kareo + PatientPop)](https://www.g2.com/products/tebra-previously-kareo-patientpop/reviews) - 4.1/5.0 (253 reviews)