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.
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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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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.
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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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Resources for Third Party Administrators
P&C Medical Payments: Stop the Fragmentation
Bodily injury now tops 26% of auto claims costs. See the 4 fault lines driving P&C medical payment fragmentation — and how a connected model fixes it.
Payment Integrity’s AI Moment: IDC Spotlight
See how AI is shifting payment integrity from post-pay recovery to pre-pay prevention. Download the IDC Spotlight report to see what's next.
The Infrastructure Behind Clear Member Communications
Clear EOBs, ID cards and enrollment materials start with connected claims data, compliance expertise and resilient operations behind the scenes.
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.
