Expert Claims Review®
Expert pre- and post-pay review to uncover coding errors and reduce overpayments on complex claims.
Zelis® Payment Integrity Solutions
Pay every claim accurately — and catch errors before they cost you.
Accurate Claims. Less Friction. Sustainable savings.
Pre- and post-pay reviews
Get it right before payment with pre-pay reviews, and resolve complex errors post-pay.
AI-enabled, expert validated
AI prioritizes, synthesizes, and accelerates; clinicians, coders, and pharmacists validate nuanced outcomes.
Transparent and provider-aware
Every decision is built to be explainable, supportable, and easier to communicate to providers.
Payment Integrity Products
Claims Editing
Expert-built edits that improve claims accuracy and fit your existing policies.
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Health Plan Reaches 90% Digital Payments
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 + ZAPP Edge)
Learn how one payer reached 70% EFT adoption, cut $400K in print and postage costs, and improved operations using advanced payment solutions.
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How Zelis Helped a Member Save $51K on Their Health Bill
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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Payment Integrity Resources
2027 Maternity Coding Changes & Payer Readiness
Maternity care moves to phase-specific CPT reporting January 1, 2027. See how the 2027 maternity coding changes affect claims edits, benefits and analytics.
The Road to Proactive Cost Containment
This Zelis eBook shows payers how to catch billing and coding errors before claims are paid, using AI and expert review.
Payment Integrity’s AI Moment: IDC Spotlight
See how AI is shifting payment integrity from post-pay recovery to pre-pay prevention. Download the IDC Spotlight report to see what's next.
