We focus on delivering Better Service and Better Performance.

Every Client. Every Member. Every Provider. Every Day.

 

 

Technology

In our experience, Zelis has gone above and beyond in helping us get set up with our EDI connection and ensuring that things are running smoothly. The people that we work with on a daily basis in regards to claims questions are amazing and extremely helpful.  We have been very satisfied with the turnaround times in regards to claims processing and daily questions.  The electronic connection has been a huge improvement over our past experiences.  It has increased our claims volume tremendously, which has also increased our savings.

Kristen Director, Regional Health Plan

Zelis brings a balance of technology and business specific knowledge to us that offers us the opportunity to offer creative and supportive solutions to meet our client’s needs. They have continued to “service” us outside of the initial sales and implementation process like no other partner. They truly have been a “solutions” partner to assist us in balancing the need for cost containment/savings with opportunities for additional revenue.

Wanda VP, TPA

Implementation

The implementation process with Zelis was painless. They formed a team of people who assisted us with making sure that all of the details were handled, and that all of our business was moved and online within 90 days from implementation.

Joanne Vice President, TPA

From the very beginning, when you start the partnership with Zelis and work with them on implementation, the Zelis team tells you exactly what’s going to happen. They form that partnership by understanding your business and seeing what your needs are. They also looked at our systems and told us exactly what to expect. From Day 1, working with the implementation team, they earned our trust.

Scott Manager, TPA

Savings

They have excelled at finding large dollar overpayments that have enabled us to exceed our goals.

Angela Manager, National Health Plan

Traditionally, handling payments manually required significant effort. Zelis’ automated service has reduced this by 4:1 for our hospital business and 6:1 for our physician business.

Su Director of Processing, Not-for-Profit Health System

We are the nation’s largest Taft Hartley TPA, and have been working with our partner Zelis for the past several years. We provide health claims services for clients demanding the best of services with fiduciary legal responsibilities to achieve the lowest cost to serve their nearly 1M members served by our organization. Our clients have enjoyed average savings of 42% off charges. In turn they’ve returned tens of millions to their trust funds, benefiting their members while reducing member liabilities. As a technology and service partner, Zelis successfully strives to innovate by investment and acquisition to drive new savings at an incredible pace. We have experienced an increased number of claims touched while keeping our level of effort stable via their superior technology. No other product or service we’ve partnered with has had the impact of Zelis.

Craig COO, TPA

Our total savings for clients in just the past year topped $4.1 million resulting in $24.98 PEPM savings. A huge benefit is the ability Zelis has in customizing what their clients need in order to tweak edits for specific services.  Being able to turn off and turn on edits per client or even apply them down to the provider level has assisted us in being able sell the Zelis suite of services.  Being able to customize a savings report specific to a client goes a long way in showing the client the value in our partnership with Zelis.

Mary COO, TPA

As we look to get our clients to their lowest cost medical spend we feel Zelis is a vital partner in that regard by providing their knowledge, technology, and services. Their combination of services – editing, negotiations, network, ERS and electronic payments all with one business partner leads to cost savings for clients and efficiency of operations leading to reduced operational costs.

Steve COO, TPA

Integration of Services

As we’ve worked with Zelis, we’ve found all of their capabilities and solutions to be very easy to plug in and integrate with our capabilities and offerings. That flexibility is very valuable to us.

Joel Executive Director, National Health Plan

Zelis rates especially high as a partner of ours with their leadership-driven vision attentively strengthening and continuously growing their offerings from within their organization as well as acquisitions of strategic organizations. Zelis’ client focused and customized solutions provide our organization with competitive flexibility through claims adjudication system integrated services and exemplary customer service. The opportunity to minimize the complications of managing multiple vendor partnerships by utilizing Zelis’ services is invaluable not to mention the measurable cost savings our plan sponsors have garnered.

Cindy COO, TPA

Pre-payment

Working with Zelis has helped us take an end- to-end approach to that problem starting with pre-payment, looking at the best way to pay those claims initially to get the best pricing available. Through the end- to-end continuum that Zelis offers we have an opportunity to work with them from pre-payment right through the payment.

Todd Manager, Regional Health Plan

Service

Zelis has a wonderful staff with whom we have enjoyed working with over the last seven years – the passion that they bring to their products and capabilities. They are responsive to our unique needs as a customer, and bring innovation and creativity. They are constantly reaching out to us, and sharing new and exciting ideas and innovations that they are working on or have available in the marketplace.

Joel Executive Director, National Health Plan

Zelis has great network access and their analytic team is awesome. One of our clients was requesting some unique reporting, and this team was able to deliver exactly what we needed with excellent time service. We recently implemented Payment Integrity and that product and have already seen significant savings. I would definitely recommend Zelis, we are a small client, but we are treated like we are their biggest client.

Jeannie Provider Consultant, Regional Health Plan

Zelis makes doing business simple. They treat us like customers and partner with us. Seems simple but it’s not our experience in the cost containment industry. Our clients are saving so much money on their claims spend that they are asking for new products.  It’s a rare treat to sit down with a client that hasn’t bought a new solution in years and is now asking for “what’s next”.  That builds loyalty

Craig COO, TPA

Zelis truly puts their money where their mouth is. They understand the value of being a partner in this industry, that has so many complicated moving parts, and everything is driven by relationships at the end of the day. And they recognized the position that we have in the industry, and they understand it, and they have been a great strategic partner for us.

Rich CFO, TPA

Our partnership with Zelis as a vendor is one of the most flexible of any we have. Zelis is also very proactive in finding new ways of cost savings for our clients and always looking have the interest of their clients in mind. Having a dedicated account manager and understanding our needs allows the account manager to make suggestions for improvements in the process. We have never had an answer of “We can’t do that?” We always hear that Zelis can see what they can do to help.

Deena COO, TPA

Zelis provides outstanding customer service. All the individuals I’ve worked with exude the same core values which live by at our organization, values of integrity, initiative, good judgment and teamwork. Zelis has been true partner in our business; demonstrating over and over a flexibility and creativity which has enabled us create solutions specific to the needs of our population. This kind of partnership strengthens the value proposition we bring to the market. Also, they helped us to become compliant with regulatory requirements through various solutions, bringing capabilities to us that we did not have in-house.

Eric Director, TPA

Expertise & Innovation

As a regional health plan, we face challenges with serving our local communities and having an understanding of what is happening on a national level. Working with Zelis helps us tackle that problem. They have knowledge beyond our region, and they help bring that information to us so that we can make smarter strategic decisions.

Todd Manager, Regional Health Plan

One benefit of working with Zelis is their flexibility to meet our ever-changing needs. Our TPA is geographically located in a very demanding “provider hotbed” so we experience excessive pushback and nonconformity which Zelis continues to put forward unique options and opportunities to allow collaborative efforts to manage the high cost of services in our member’s complex medical care market.

Cindy COO, TPA