Claims Optimization
Capture savings earlier and reduce waste across all claims types.
Zelis® for Benefit Consultants & Brokers
Give clients clearer paths to savings and stronger plan performance.
Find support for every client need
Payments Optimization
Move to electronic payments for lower costs, improved speed and strengthened relationships.
Member Communications
Reduce complexity and move members from confusion to clarity.
Member Engagement
Help members find the right care at a cost they can afford.
Network Management
Build and manage networks that support access, savings and quality.
-
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.
Read more -
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.
Read more -
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.
Read more -
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.
Read more
Resources for Benefit Consultants & Brokers
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.
Benefit Consultants and Brokers’ Frequently Asked Questions
Zelis helps consultants and brokers give clients clearer insight into plan performance, network access, care gaps, payment processes and savings opportunities.
Yes. Zelis helps uncover savings opportunities across networks, in- and out-of-network claims by deploying payment integrity capabilities and using a multi-channel savings approach.
Zelis provides tools and insights that help compare network access, cost, quality and performance against client goals and market needs.
Yes. Zelis provides brokers with location-based reporting and provider access insights through Broker Connect. Using Zelis proprietary data, brokers can search by city, state, county, or ZIP code and filter providers by specialty and reference-based pricing acceptance status. Results are displayed visually on a map, including the number of available providers in a selected area.
These insights help brokers evaluate provider accessibility, address employer concerns about reference-based pricing adoption, and give self-funded groups greater confidence when considering Zelis Open Access Pricing® or another RBP plan.
Performance and payments reports that make it easier to show clients where their plans are working well and where they can improve.
Zelis supports health plans, third-party administrators, property and casualty plans and other payer organizations looking to improve savings and performance.
Zelis gives consultants and brokers practical tools, data and healthcare claims and payment expertise to help clients improve plan value and member experience.
