Your Expert Partner in Out-of-Network Health Bill Support

Transform your member experience with expert out-of-network balance bill navigation.

Dive Deeper

Bridge gaps in the healthcare financial system and align the interests of all.

Dealing with out-of-network healthcare bills can be challenging for members, causing confusion and unexpected financial strain. This often leads to decreased member satisfaction and increased frustration for employer groups.

Zelis Health Bill AssistSM is designed to address these issues by offering specialized out-of-network bill support. Unlike other benefit solutions focusing on patient financing or provider payments, our service employs a dedicated navigation team to provide a comprehensive, market-leading solution focused on out-of-network benefit education.

How Health Bill Assist Helps

Zelis Health Bill Assist uses an integrated approach to maximize value for you and your members. Our technology and expertise ensure that members receive comprehensive support throughout their billing journey.

Clear communication & education

We take a proactive outreach to ensure members receive crucial information when out-of-network claims are processed. Our experts explain healthcare claims, the impact out-of-network services, and billing nuances related to plan benefits.

Expert navigation services

Our team delivers streamlined support for out-of-network claims processing, negotiations and benefit applications. We facilitate direct communication between payers and providers and clarify benefit structures, ensuring a seamless experience for members.

Investigation and resolution of billing issues

We investigate and correct billing discrepancies, seeking claim corrections to reduce member costs. Our commitment to accuracy results in significant savings for your members.

Negotiation expertise

Utilizing our strong provider relationships and advanced negotiation strategies, we work to reduce out-of-pocket costs for members.

Why Zelis?

Enhance member experience, reduce costs, and improve outcomes.

Transform your member experience by providing robust navigation support for out-of-network health bills. By partnering with Zelis to offer this level of support, health plans can enhance member satisfaction and loyalty, creating a more efficient and supportive healthcare environment.

Leaning into our proven innovation, service and expertise can accelerate downstream impact and strengthen relationships. Together, we can empower members to make informed choices, mitigate financial challenges and achieve better healthcare outcomes.

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Explore the Benefits of Health Bill Assist

Frequently Asked Questions from Providers

Helping health plan members navigate out-of-network bills offers substantial value to healthcare providers. Our service aims to help providers reduce administrative burden, improve cash flow, decrease uncompensated care, and enhance patient satisfaction. By supporting participating members with balance bills, health plans and providers together create a more efficient, supportive, and patient-centered healthcare system.

Providers work with Zelis to increase cash flow by extending discounts to members in exchange for expedited payment. We contact providers on behalf of members who have a high propensity to pay but are struggling with the cost of the bill. This dynamic incentivizes the provider to engage in the negotiation process, resulting in a win win situation.

Zelis health bill navigators facilitate calls between members and providers to reduce strain on the member and streamline the process. Our team of highly skilled experts has healthcare experience and an expansive understanding of different types of health plans and how benefit structures work.

Since Zelis Health Bill Assist negotiations are based on the member’s cost share, the provider is agreeing to reduce what the member owes to expediate payment. That payment is sent from the member to the provider.