Solutions
Together, we can modernize the healthcare financial experience.
It’s no secret: the healthcare system is deeply fragmented, and more inefficient than ever.
Traditional, siloed approaches will not fix this antiquated system. It will take an integrated platform encompassing network analytics, payment integrity, electronic payments, and member communications. A platform built with agile technology to bring payers, providers and consumers together – and infuse new levels of care to every healthcare claim.
We’re building Zelis as a connected platform to fix:
*NEJM, “Tallying the Waste in American Healthcare,” Jan. 5, 2021
A bold new world.
We’re taking a holistic approach that removes friction from the entire healthcare financial experience by focusing first on pre-service and pre-payment: because clean, accurate data at the outset streamlines payments and leads to savings and efficiency for all participants.
Our Solutions
Purpose-built approach.
We’ve built Zelis from the ground up to address the most abrasive aspects of the payment process. The only way to deliver on our promise to help you pay for care, with care is by identifying and solving the most complex steps of every healthcare transaction.
Payment Integrity
Pre-payment savings on every claim.
Ensure accurate payments with in-depth clinical and financial reviews prior to processing.
Identify and correct coding errors before payments are processed.
Out-of-Network Solutions
Multi-layered approach minimizes abrasion and delivers measurable savings.
Achieve appropriate claims costs using integrated technology, coding expertise and historical benchmarks.
Build a model pricing strategy that improves transparency, reduces provider abrasion and drives savings.
Take advantage of tailored network design and access to more than 1.M medical, dental, property and casualty providers.
Gain the insight and tools you need to comply with new balance billing regulations set to take effect in 2022.
Payments Optimization
Transform how providers get paid and drive member satisfaction with clear communications.
Reduce the cost of making payments while driving provider satisfaction with our integrated electronic payments solution.
Enroll in Zelis ACH and get paid faster and the way you want, while also reducing costs.
Simplify design and streamline distribution to ensure members have critical plan information when they need it most.
Consolidate claim communications, including EOBs, with episodic, rather than transactional, EOBs.
Networks
Build, access and manage competitive, cost effective, and compliant networks.
Build and optimize competitive, accessible, and high value networks to win market share and meet your members’ needs.
Track competitor activity and market opportunities to refine your network strategy, identify the best providers to maintain competitiveness, and communicate the strength of your network.
Streamline provider directory and consulting with faster, more accurate data collection and verification.
Access the right provider coverage with our simple, customizable network solutions that drive in-network savings and mitigate out-of-network costs.
Set limits on rising healthcare costs and free members from network limitations.
Take the Next Step
Friction in healthcare payments ends here. Let us show you how.
