Build the connections that optimize every payment.
Streamline, balance and clarify the entire payments process.
We believe the key lies in creating stronger connections between you, your providers, and your members – and we’re building the technology and processes that are making it happen.
By addressing the most abrasive aspects of the payments process, we’re purposefully evolving your existing process to help you reduce friction and control the rising cost of care.
Ensure the accuracy of every payment
Balance risk and financial performance
Analyze and optimize network performance
Develop primary, secondary, wrap and specialty networks
Comply with new and changing regulations (No Surprises Act)
Clarify member enrollment and claims communications
Solutions for Health Plans
Here’s how we help improve your operational efficiency:
Ensure accurate payments with in-depth clinical and financial reviews prior to processing.
Identify and correct coding errors before payments are processed.
Achieve appropriate claims costs using integrated technology, coding expertise and historical benchmarks.
Build a model pricing strategy that improves transparency, reduces provider abrasion and drives savings.
Give members access to their preferred providers with tailored access to Medical, Dental, and Property and Casualty providers.
Learn more about our payment integrity and network solutions.
Bring clarity and consistency to member ID cards and episodic, rather than individual, EOBs.
Simplify design and streamline distribution to ensure members have critical plan information when they need it most.
Streamline provider directory and consulting with faster, more accurate data collection and verification.
Learn more about claims communications and our network solutions.
Leverage flexible payment options that balance cost effectiveness with provider satisfaction, allowing you to minimize abrasion and continuously expand your network.
Streamline and speed up payment receipt and reconciliation throughout your organization with 835 system integration, easy routing to multiple TINs and enhanced security.
Learn more about our payments optimization platform.
Build and optimize completive, accessible, and high value networks to win market share and meet your members’ needs.
Track competitor activity and market opportunities to refine your network strategy, identify the best fit providers to maintain competitiveness, and communicate the strength of your network.
Learn more about our network solutions.
A BCBS plan saves $1.2M annually.
A BCBS plan reduced operational fulfilment costs and increased electronic communications delivery and provider satisfaction with Zelis Payments Optimization.