Contract Modeling
Client-specific contract insights to improve plan performance and negotiations.
Zelis® In-Network Pricing Solutions
Accurate contracted claims. Complete transparency. Smarter negotiations.
Accuracy, Transparency and Control — All in One Place
Accurate contracted claim pricing
Price any contracted rate — commercial, Medicare, Medicaid, Tricare and more — in seconds.
Full process transparency
Process trails show exactly how each claim was priced, with line-level formula and edit logic.
Benchmark and contract modeling
Benchmark provider rates to Medicare, Medicaid, direct contracts, or in-network MRF data.
In-Network Pricing Products
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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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Proven Savings with SmartShopper
Discover the findings of the Wakely report, highlighting savings of $552 through SmartShopper participation and care transparency.
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Zelis Health Bill Assist℠ helped cut $52,000 in medical costs
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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Explore All In-Network Pricing Resources
Reimagining P&C Claims Performance Webinar
Learn how P&C insurers can modernize medical payments, reduce manual work, accelerate claims workflows and improve claimant and provider experiences.
Payment Integrity Vendor Selection White Paper
See how US healthcare payers can choose the right payment integrity vendor, reduce provider abrasion and improve retained savings with smarter claims strategy.
Claims Analytics for Denial Management & Compliance White Paper
Learn how providers use claims analytics to spot denial patterns, reduce rework, manage compliance risk, and improve revenue cycle performance.
