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
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.
Everest Group 2026 Pre-Payment Integrity Report
Download Everest Group’s 2026 Pre-Payment Integrity PEAK Matrix report to see why Zelis was named a Leader for prevention-first payment accuracy for payers.
NSA Compliance Guide — Payers and Providers
Learn No Surprises Act compliance requirements for payers and providers, including QPA, IDR, open negotiation, and strategies to reduce disputes.
