Established Reimbursement Solution
OON pricing that holds up: market-based reimbursements, strong savings and lower provider friction.
Zelis ClaimPass®
Route every out-of-network claim to maximum savings — automatically, with AI-powered optimization.
Smarter Savings and Less Friction on Every Out-of-Network Claim
AI-powered dynamic routing
Route every OON claim to the best savings channel — our optimization engine handles every option.
Configurable to your plan goals
Customize down to employer group, service type and member level for flexible, plan-specific control.
Real-time market intelligence
Align pricing to plan preferences to improve precision, consistency and financial performance.
What’s Inside ClaimPass®
Supplemental Network Pricing
Apply contracted discounts to OON claims via local, national and specialty network partners.
Expert Negotiations
Experienced negotiators identify maximum OON savings opportunities
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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 ClaimPass Resources
Provider Payment Portal Integration Guide
Learn how provider payment portals integrate with EHR and billing systems, what data migration requires, and how long setup typically takes.
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.
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.
