Claims Optimization
Maximize savings on every claim, unlock revenue and simplify complex workflows.
Zelis® for Third Party Administrators
Find savings, simplify workflows and help clients get more from every plan.
Explore Solutions Built for Third Party Administrators
Payments Optimization
Fortify strategies, discover savings earlier and stay ahead of changing requirements.
Member Communications
Deliver better communications to plan members.
Member Engagement
Empower plan members to find the right care at an affordable cost.
Network Management
Build, maintain and optimize high-performing provider networks to meet employer population needs.
-
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 Third Party Administrators
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.
Third Party Administrators’ Frequently Asked Questions
Zelis helps TPAs find savings, improve network performance, simplify payments and deliver clearer communications for clients and members.
Yes. Zelis helps TPAs uncover savings across claims, networks, payments and out-of-network costs before waste becomes harder to manage.
Zelis helps TPAs analyze network performance, fill access gaps and build primary, secondary, wrap and specialty networks.
Keep reading: Network Management Solutions
Yes. Zelis helps TPAs manage payments from start to finish with tools that reduce manual work and make the process easier to control.
Keep reading: Payments Solutions
Zelis helps TPAs send clearer enrollment and claims communications so members better understand their benefits and next steps.
Keep reading: Member Communications Solutions
Zelis brings network, claims, payment and communication tools together so TPAs can work smarter and deliver more value to clients.
