Claims Optimization
Optimize networks, maximize savings on every claim while minimizing provider friction.
Zelis® Healthcare Payer Solutions
Drive measurable ROI with a partner built to scale across the entire financial ecosystem.
Solutions For Every Type of Payer
Optimize performance and modernize workflows with solutions tailored to your business needs.
Drive efficiency while improving provider and member experiences.
Learn moreSimplify complexity of medical claims payments.
Learn moreMaximize claim savings and revenue with scalable, branded experiences.
Learn moreUse actionable analytics to prove value, control costs and compete.
Learn moreImprove efficiency & enhance satisfaction with our integrated payments platform.
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Explore Our Healthcare Payer Solutions
Payments Optimization
Simplify payments, gain operational efficiencies and strengthen provider and member trust.
Member Communications
Reduce complexity and move members from confusion to clarity.
Member Engagement
Empower your members to find the right care.
Network Management
Build, maintain and optimize high-performing provider networks.
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Health Plan Reaches 90% Digital Payments
See how a regional healthcare payer expanded ERS market-based pricing to grow out-of-network savings while keeping provider disputes low.
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How One Payer Used Market-Based Pricing to Drive Out-of-Network Savings
See how a regional healthcare payer expanded ERS market-based pricing to grow out-of-network savings while keeping provider disputes low.
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Better Outcomes Before IDR: A TPA Case Study in NSA Performance
Explore how to use AI and automation improve healthcare claims management and how collaborating with experts can help.
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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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Resources for Payers
2027 Maternity Coding Changes & Payer Readiness
Maternity care moves to phase-specific CPT reporting January 1, 2027. See how the 2027 maternity coding changes affect claims edits, benefits and analytics.
Bridging Healthcare Payment Gaps
Payers and providers agree on healthcare's biggest problems. See where payment gaps persist and 4 steps to turn payer-provider alignment into shared results.
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.
