Modernize operations
We help you in your digital transformation journey, as a connected platform or with purpose-built solutions.
Zelis® for Payers
Scale and grow with an independent partner that’s willing to deeply understand and flex to your business through deep visibility across the financial ecosystem of healthcare.
Payer Use Cases
Optimizing your performance and modernizing your business.
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.
As healthcare costs continue to rise, and as new regulations take effect across the country, there’s more pressure than ever on property and casualty carriers. Zelis is here to bring you a tailored single-point solution that includes electronic payments, balanced network design, and leading-edge analytics to auto and worker’s compensation plans.
No one else in the industry gives TPAs more tools to integrate network analytics, network access and management, payment integrity, electronic payments, and member communications.
The result? Deep insights that lead drive clarity, savings, and efficiency at every step. We’re looking at the entire claims process, starting at pre-payment, to help you spot errors early and uncover savings opportunities less integrated solutions might miss. We’re also helping you proactively build and optimize your network, ensuring you’re delivering the coverage your members need.
Your clients value your input – and Zelis can help you make your relationships even stronger. Partner with us, and we’ll put the industry’s most advanced analytic tools at your fingertips.
Zelis Network Analytics allows you to consult with your clients on a whole new level. You’ll bring competitive and performance insights to the table, uncovering gaps in their networks and comparing their network performance to key competitors. You’ll bring real insights to the table – insights health plans and TPAs can use to improve member service, optimize network performance, and reduce costs.
Control rising costs, gain efficiencies and improve provider and member satisfaction for your dental organization by leveraging our connected platform for network and payment solutions.
Key Use Cases
- Proven track record of results in claim and payment savings.
- Deep expertise and analytics in network performance, access and care guidance.
- Digital-first intuitive care shopping, selection, and rewards.
- Ability to balance risk and financial performance.
- Flexible financial models that align to mutual success.
From the start, Network360® has been a wildly successful program that has impacted our ability to meet goals and grow our business.
Zelis has always given us the tools we needed to succeed. Working with their team has helped us navigate the constantly changing demands of the market that are generated by our clients’ needs, regulatory issues, and the passage of new legislation. We have a level of confidence that when something new comes up, we’re going to work with Zelis to solve the problem.
Zelis listens to our business needs and growth strategy, and anticipate how ACS can continue to deliver results for our clients. We have a comprehensive partnership across many different solutions, and we are continuing to expand.
Request a Meeting
Let’s talk about modernizing your business.
There’s no shortage of ways we can help. Get a conversation going with one of our Solution Advisors and build a thoughtful approach aligned to your business goals.
Connect with usResources for Payers
Reimagining P&C Claims Performance Webinar
Learn how P&C insurers can modernize medical payments, reduce manual work, accelerate claims workflows and improve claimant and provider experiences.
View resource Everest Group 2026 Pre-Payment Integrity Report
Download Everest Group’s 2026 Pre-Payment Integrity PEAK Matrix report to see why Zelis was named a Leader for prevention-first payment accuracy for payers.
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NSA Compliance Guide — Payers and Providers
Learn No Surprises Act compliance requirements for payers and providers, including QPA, IDR, open negotiation, and strategies to reduce disputes.
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Zelis Recognized by Everest Group for AI-enabled Pre-payment Integrity Solution
Zelis has been recognized as a Leader in Everest Group’s Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026.
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NSA IDR Final Rule Blog
Learn what the NSA IDR final rule means for payers, TPAs and health plans, including Gateway readiness, coding updates and phased compliance next steps.
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Payment Integrity Vendor Selection Infographic
Download the infographic to evaluate payment integrity partners, pressure-test ROI and connect pre-pay prevention with post-pay claims intelligence.
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