Zelis reviews more than $140+ billion in claims.

We combine leading-edge, machine learning-enabled technology with superior clinical expertise and integrate network, claims and payments data to generate insights that drive actions that maximize claims cost savings.

We maximize claims cost savings by finding and reducing provider errors, waste and abuse using our proprietary claims editing, specialty clinical audits, dialysis savings, clinical bill review and audit and out-of-network solutions.

CLAIMS EDITING

Generating fast, accurate, industry-compliant claims analysis.

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CLINICAL BILL REVIEW & AUDIT

Uncovering coding errors and inappropriate charges.

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SPECIALTY CLINICAL AUDITS

Review of high cost specialty drugs and complex spinal and biologic implants.

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DIALYSIS SAVINGS & SUPPORT

Maximizing savings for high cost dialysis claims.

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OUT-OF-NETWORK SERVICES

Ensures optimal cost-savings on out-of-network claims.

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