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ValueHealth Benefit Administrators

VHBA partnered with Zelis to improve services, modernize processes, increase client value, and streamline member experience.

The Challenge

ValueHealth Benefit Administrators (VHBA) needed a partner solution that gave them the flexibility to create customized solutions while still bringing value to clients.

The Solution

After partnering with the Zelis team, VHBA replaced its time-consuming manual editing processes with automated bill review and audit to ensure pre-payment claims accuracy. Later, they expanded into other Zelis solutions, including out-of-network solutions, pioneering electronic payment options, and the Zelis DOCS® platform.

21 M
Total annual savings
13 yr
Length of partnership

100 K
Savings realized after modernization

A deeper look

A 13-year innovative partnership that’s just getting started

The Challenge

Providing affordable coverage for high-risk members

Among several customized plans managed by VHBA are several state and federal plans that provide coverage for high-risk members with serious illnesses who can’t obtain insurance elsewhere.

To make affordable insurance available to these vulnerable member populations, VHBA collaborated with Zelis to develop cost-effective coverage plans and seek out new insurance networks.

The Solution

Enhancing and modernizing VHBA’s operations

“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.” – Hilary Chapman, Operations Manager of VHBA

Utilizing Hospital Bill Review, Claims Editing, Out-of-Network solutions, and other products, the partnership with Zelis has resulted in more than $21M in annual savings for VHBA.