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.
We help you reduce friction for your providers and members while controlling the rising cost of care. Zelis partners with more than 25 Blues plans, improving the healthcare journey for more than 95 million members. Our solutions are purpose-built to uphold all BCBS® Association and ITS requirements, and configurable to adapt to future Blues mandates and requirements.
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.Â
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.
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.
Our relationship with Zelis has given us the flexibility to create customized solutions and bring value to our clients. The solutions and expertise that Zelis brings to the table, as well as its team’s ability to develop ideas to improve our processes, have created a mutually beneficial relationship for both our companies.
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.
Top Resources for Payers
News
Zelis® and Google Wallet Bring Security, Convenience, and Efficiency to Healthcare Consumers
Zelis transforms the healthcare financial experience: payer clients can now offer secure digital health insurance ID cards in Google Wallet.
View resourceBlog
5 Ways Healthcare Payers Can Improve Provider Satisfaction
Simplifying healthcare payments can deliver numerous benefits to both providers and membersKeyword: provider satisfaction
View resourceBlog
Going Green: How Health Plans are Driving Sustainability through Digital Payments
Modernizing healthcare payments can make a meaningful impact on eliminating waste and supporting the environment.
View resourceNews
Zelis® Named to Fortune’s 2023 Best Workplaces in Health Care
Zelis has been named by Fortune as a 2023 Best Workplace in Health Care. Among a list of 40 large workplaces, Zelis ranked at #16 in its debut on the list.
View resourceBlog
Caution: Bumpy Road Ahead
Don’t fall behind on your goals. Learn how to navigate 2023’s main health plan challenges while still empowering progress and efficiency.
View resourceBlog
Unraveling the NSA: Assessing HHS’ first annual report
On July 6, 2023, HHS released their first annual No Surprises Act (NSA) report. Get the details and implications here.
View resource
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