Built for:
Third-Party Administrators
Focus on comprehensive solutions to uncover real savings.
Streamline and optimize every step of the payment process.
Healthcare costs are rising – and we believe the key to staying competitive in lies in taking control of the entire process. At Zelis, we’re building a holistic solution that drives savings and payment optimization across the claims lifecycle.
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.
Analyze and optimize network performance
Access targeted supplemental networks to cover gaps in care
Model and build primary, secondary, wrap and specialty networks
Gain efficiency with a single point of contact for pre-payment optimization
Take control of the payments process from beginning to end
Engage members with clear enrollment and claims communications
Solutions for Third-Party Administrators
Here’s how we work with you to deliver savings:
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.
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.
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.
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.
Case Study
Third-Party Administrator ACS Benefit Services realizes $13M in Savings
By choosing to add Zelis as their external partner for healthcare bill reviews, edits, and audits, ACS has converted more than 300,000 paper payments to electronic modalities and realized $13M in gross savings since 2018.
Zelis by the Numbers
Join us as we chart new ways to pay for care, with care.
Take the Next Step
Learn how we can help you take a more modern approach to payments.
