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Solutions / Healthcare Intelligence

Healthcare IntelligenceSM

Advance your market position with visibility across in-network rates.

Get rates-based intelligence across the continuum.

With the Transparency in Coverage Rule, over a billion new rates-based data sets are now publicly available via machine-readable files, giving payers the opportunity to make strategic decisions based on market contract pricing data. However, the data on its own is messy, incomplete, and hard to use.

Unlock the value of contracted rate data to deliver insights that empower a range of plan functions including network, provider contracting, finance, strategy, and sales with Healthcare IntelligenceSM by Zelis.

Seamlessly partner with a single organization who has visibility across the healthcare continuum, with a strong foundation delivering payer transparency MRFs, cost solutions, and network analytics. 

Seamlessly meet compliance requirements.

Inform network design with market insights on cost and quality.

Easily understand the impact of contract changes on total cost.

Compare INN rates with peers across the market to the service level.

A Comprehensive Rate Intelligence Platform

Stay competitive through deep market insights.

For Finance

Better understand how your cost position compares to the market to hone financial planning and expansion discussions.

Flexible, guided report configuration makes it easy to set up a new analysis to fit your needs. You can quickly change parameters and see the impact on your results.

For Network Operations

Understand opportunities and risks around your INN contracted rates as compared to the market to support provider contracting and negotiation.

Easy navigation between report views to dig deeper into the analysis and uncover key insights.

For Strategy & Intelligence

Make strategic decisions for geographic-based plan growth, like entering or exiting markets, based on cost and provider performance.

Clear data visualizations make it easy to understand complex data and provide a view into the distribution of providers by billing class, specialty, and geography across data sources.

For Sales & Marketing

Leverage pricing data to showcase plan value and win deals by quantifying product value and demonstrating how your plan offers
the best price for common services.

How Healthcare Intelligence Works


Collect and collate claims and rate data from multiple MRF file sources across disparate systems.


Normalize data across sources using schema validation and quality assurance practices.


Enrich data with provider demographics, EINs, and specialty to billing code mapping.


Develop business rule engine and orchestration so data is comparable in like-to-like cohorts.


Access deep insights through web-based application dashboards.

Take the Next Step

Gain transparency into market rates to enhance your competitive position.

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