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Provider Decision Support

Managing data for a smoother provider search experience.

Provider Decision Support UI

Create custom provider search solutions with ease.

With multiple data sources and conflicting information, building a robust provider search can be a time-consuming process. Zelis takes a multi-layered approach to deliver the fastest, most reliable provider search solution for your network.

Built for benefit administrators, consultants, brokers, healthcare IT partners and exchanges, Zelis’ Provider Nexus cleans, organizes and standardizes the best available data from multiple carriers to put the most reliable provider information within your reach.

This nationwide provider database is just the tip of the iceberg. Using our highly configurable Provider Nexus API, your developers can seamlessly integrate search queries (endpoints) and results into your platform. You can filter by your own attributes, including premium designations, centers of excellence, enrollment codes and PCP IDs.

Provider Nexus is only possible because our partners – both our clients and carriers – trust us to protect and maintain the integrity of the provider data, while using it to deliver the best possible service.

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Consolidated Provider Database

We support the full spectrum of direct carrier data sources including commercial, Medicare, exchange, vision, dental, and behavioral health.

Robust Algorithm

Filter and standardize data based on matching identifiers, geographic proximity, specialties and common name patterns.

Compatibility, Guaranteed

Try before you buy, with a 30-day test to ensure Provider Nexus achieves your goals before you invest a single penny in our solution.

Configurable API Implementation & Documentation Library

Our agile API adjusts to your workflow, delivering exactly the variables your developers need supported by our comprehensive documentation written by developers for developers.

Secure Connections

Spot application errors before they cause disruptions in service with constant, automated API monitoring.

Market-Leading Support

Work directly with data experts from Zelis to track down and collaborate with carrier data teams to correct data problems ASAP.

API Documentation Library

A comprehensive documentation written by developers for developers.

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Get an inside look at the market.

Market360 is a ready-to-go provider network dataset covering the vast majority of national and regional payers. This Zelis network-tagged provider data has healthcare IT, health plan consultants, brokers, and research companies covered for individual and family, small, mid- and large-group, Medicare, Medicaid and dental network providers.

For benefit administrators, consultants and brokers, healthcare IT partners and exchanges

Provider Nexus can help you:

  • Maintain the integrity of provider network data
  • Build single- and multi-carrier provider search solutions
  • Identify and correct discrepancies in network information
  • Standardize provider information according to internal business rules
  • Provide members with the most reliable provider search tools
  • Offer scalable solutions to unique needs to large enterprise implementations

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Provider Decision Support in action.

Take the Next Step

Better provider search begins with better data.

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