Zelis is the only company in the industry that delivers a tailored solution for any payer that is looking to minimize claim cost and maximize savings. By using Zelis’ Network PLUS, payers take advantage of our scalable and sustainable cost management solutions that fit every configuration of a client’s needs. Using proprietary technology and an array of solutions to effectively manage pricing for claims, Zelis’ Network PLUS balances the needs of all stakeholders-payers, plan sponsors, members, and providers.
Utilizing sophisticated analytics and drawing from over 25 years of expertise in claims cost management, we recommend and administer a network cost and Referenced Based Pricing (RBP) strategy that meets each client’s unique business requirements. The results? Competitive savings. Low appeals rates. Managed balance billing. Member satisfaction. And a solution that’s flexible to every configuration and scales as groups and covered lives are added.
When integrated with our Reference Based Pricing solution, Zelis’ claim settlement and member advocacy services provide balance billing support through its proactive post-payment settlement program.