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.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.
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
Blog
Accelerating Progress in Healthcare Finance: A Call to Action
Zelis drives healthcare financial change through innovation, data and payment optimization. Solutions built for real healthcare challenges.
View resourceBlog
How Top Healthcare Teams Tackle Payments in a High-Pressure Landscape
Discover how top healthcare teams tackle payment challenges to reduce denials and improve financial performance.
View resourceBlog
Driving Efficiency and Better Financial Outcomes in the Revenue Cycle
Discover strategies to streamline your revenue cycle, reduce costs, and improve financial outcomes for healthcare organizations.
View resourceBlog
​Reimagining Out-of-Network Billing Support for the Modern Payer
​Explore how modern payers are transforming out-of-network billing support with member-centric strategies.
View resourceBlog
Understanding Schema 2.0
CMS unveils TiC Schema 2.0 with key MRF changes to boost efficiency, cut file size and guide payers toward smoother compliance by 2026.
View resourceCase Studies
How one health system manages high payment volume in half the time
See how one large health system cut payment reconciliation time in half and streamlined high-volume payments with Zelis.
View resourcePlaybooks
Digital Payments are the New Standard
Get the ebook on digital payments and their impact on modern financial transactions and consumer convenience.
View resource
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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.
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