Expert Claims Review®
Expert pre- and post-pay review to uncover coding errors and reduce overpayments on complex claims.
Zelis® Payment Integrity Solutions
Pay every claim accurately — and catch errors before they cost you.
Accurate Claims. Less Friction. Sustainable savings.
Pre- and post-pay reviews
Get it right before payment with pre-pay reviews, and resolve complex errors post-pay.
AI-enabled, expert validated
AI prioritizes, synthesizes, and accelerates; clinicians, coders, and pharmacists validate nuanced outcomes.
Transparent and provider-aware
Every decision is built to be explainable, supportable, and easier to communicate to providers.
Payment Integrity Products
Claims Editing
Expert-built edits that improve claims accuracy and fit your existing policies.
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B2B Provider Payments: Customer Success (ZAPP + ZAPP Edge)
Learn how one payer reached 70% EFT adoption, cut $400K in print and postage costs, and improved operations using advanced payment solutions.
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How Zelis Helped a Member Save $51K on Their Health Bill
Discover how expert advocacy and support from Zelis Health Bill Assist helped one member save $51,000 on an out-of-network medical bill.
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All Payment Integrity Resources
The Road to Proactive Cost Containment
This Zelis eBook shows payers how to catch billing and coding errors before claims are paid, using AI and expert review.
Payment Integrity’s AI Moment: IDC Spotlight
See how AI is shifting payment integrity from post-pay recovery to pre-pay prevention. Download the IDC Spotlight report to see what's next.
Healthcare Fraud, Waste and Abuse Guide
Learn what fraud, waste and abuse mean in healthcare, how to spot FWA indicators, and how payers can reduce improper payments with stronger payment integrity.
