Payments Optimization
Streamline payment operations and cut administrative cost through one integrated platform.
Turn Complexity Into Clarity
Reduce payer operational complexity across pricing, payments and engagement — and move as one.
Payer Operational Complexity: Where Is Yours?
Unified Healthcare Payment Systems
Discover how payers modernize healthcare payments with unified systems. Learn to simplify payments and communications—without starting over.
NSA Operational Maturity
Learn how payer teams can reduce complexity, manage disputes, and improve efficiency with a four-force operational framework.
Provider Abrasion in Payment Integrity
Learn how payers can reduce provider abrasion with the Triple E framework: Enable, Educate, Engage.
Take Control of Payer Operational Complexity
Break free from fragmented tools
Consolidate scattered solutions to reduce rework and restore control.
Protect cost and compliance
Align pricing, payments and compliance processes to reduce leakage and risk.
Improve the user experience
Unite workflows and give providers and members faster, more consistent service.
Restore operational confidence
Find where breakdowns happen and realign workflows for speed and precision.
Go From Financial Friction to Financial Flow
Years of implementing point solutions have created a fragmented “Frankenstack” that’s eroding control over cost, compliance and the user experience. Relieve pressure where it matters most — so pricing, payments and engagement move as one.
Watch how fragmented systems create complexity across the healthcare financial experience — and how a more connected approach helps you move from financial friction to financial flow.
Watch how fragmented systems create complexity across the healthcare financial experience — and how a more connected approach helps you move from financial friction to financial flow.
Zelis Solutions for Payer Operational Complexity
No Surprises Act (NSA) Compliance
Navigate NSA with configurable solutions and expert guidance that reduce disputes and cycle time.
Payment Integrity Solutions
Reduce inaccurate payments with claims editing and complex claims review.
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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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B2B Provider Payments: Customer Success (ZAPP + Zelis Payments Network)
Watch as Zelis experts explain the White House’s executive order and its impact on price 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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How one health system manages high payment volume in half the time
See how one large health system cut payment reconciliation time in half and streamlined high-volume payments with Zelis.
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Frequently Asked Questions About Healthcare Payment Complexity
Healthcare payment complexity is friction — when payment workflows, pricing and compliance run on disconnected systems. It shows up as manual work, slower resolution, inconsistent experiences and higher risk. Reducing complexity starts by identifying where breakdowns occur — and aligning workflows to move as one.
Fragmented workflows increase manual work, slow resolution and add operational cost — creating leakage that pressures margins over time.
Operational complexity builds when teams rely on layered point solutions, inconsistent data and disconnected processes that require workarounds to get work done.
NSA compliance demands consistent pricing interpretation, aligned teams, and clear workflows — disconnects can increase disputes, cycle time and risk.
Start where escalations happen most often and where cycle time stalls. One high-impact improvement creates momentum — and makes the next step easier.
