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.

Woman working at computer

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.

Explore use cases

We help you reduce friction for your providers and members while controlling the rising cost of care. Zelis partners with more than 25 Blues plans, improving the healthcare journey for more than 95 million members. Our solutions are purpose-built to uphold all BCBS® Association and ITS requirements, and configurable to adapt to future Blues mandates and requirements.

Explore use cases

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.

Explore use cases

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. 

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.

Explore use cases

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.

Explore use cases

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.

Zelis Powers Payers

Partnering with over 700 insurance companies.

Modernize operations

We help you in your digital transformation journey, as a connected platform or with purpose-built solutions.

Drive savings

We help you identify areas of your business where you can optimize savings using our healthcare expertise and automation.

Balance risk

We help you minimize provider abrasion and security risks in your financial 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.
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

Navigating 2023: A Year of Integration, Innovation, and Ease in Healthcare Solutions

Navigating 2023: A Year of Integration, Innovation, and Ease in Healthcare Solutions

Recap the healthcare solutions of 2023 and discover the strategies shaping an accessible, innovative, and efficient future.

View resource

Blog

The Data Revolution: Coming to a Healthcare Industry Near You

The Data Revolution: Coming to a Healthcare Industry Near You

Amanda Eisel discusses the role each of us plays in advancing the healthcare industry and dives into the driving force behind it all: data.

View resource

Blog

How Payers Can Reduce Operational Risks and Boost Efficiencies

How Payers Can Reduce Operational Risks and Boost Efficiencies

Discover insights from Zelis and Healthcare Dive’s latest survey, revealing common obstacles and the push for consolidated platforms.

View resource

News

SmartShopper Propel

Zelis® Launches SmartShopper Propel Solution to Enhance Healthcare Quality and Economic Outcomes for Consumers

SmartShopper Propel is an omnichannel member activation solution designed to enhance healthcare quality and economic outcomes for consumers.

View resource

Blog

NSA Updates

NSA Updates: IDR Registry Coming Your Way

Zelis Chief Legislative Affairs Officer Matthew Albright shares the latest NSA news and explains how it will impact payers.

View resource

Blog

Two-Minute Take: The Provider Experience

Jamie Brocki, VP Customer Experience, sheds light on the provider experience & how payers can support providers in meeting digital demands

View resource

Playbooks

Three Ways to Keep Blues at the Forefront of Modern Healthcare

Learn three ways Blues plans can modernize the claims and payments experience, improve member satisfaction and reduce provider attrition

View resource

Playbooks

The Data Revolution: Coming to a Healthcare Industry Near You

Prepare for the Future of Healthcare Payments

Discover four key strategies for addressing industry headwinds and improving payments processes for payers, providers and members.

View resource
Request a Meeting

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.

Connect with us