Ensure accurate payments with Zelis.
Ensure the accuracy and integrity of claims – before you pay. Pre-pay payment integrity solutions ensure a positive financial experience for your providers and reduce billing inaccuracies for your members.
Fortify your payment integrity in the face of new pressures and complexities: discovering savings earlier that stick the first time, with an eye towards the future to help you prepare for, and navigate, evolving requirements and bill provider trends.
Payment Integrity Suite
Customizable solutions that ensure payments are accurate and appropriate.
Improve payment accuracy with a holistic approach to claims editing, using a combination of a growing library of edits, historical data, industry knowledge, and the expertise of a team of certified professional coders, registered nurses, and medical doctors.
- Pay claims on time when they are right and deny when there are potential errors.
- Leverage our Clinical Coding Policy expertise to enhance your operations and identify and enforce claims that fall within the clinical gray areas.
- Optimize revenue opportunities with expert analysis and recommendations on your claims payments and trends.
- Reduce claim appeals with adherence to coding standards.
- Customize claim editing process to meet in-house guidelines.
Uncover coding errors and inappropriate charges with itemized bill review, advanced clinical chart audits, and DRG validation prior to payment.
- More than just software with a solution supported by remarkable people and service.
- Customize audits to align with plan policies.
- Drive maximum savings.
- Avoid pay-and-chase scenarios with pre-payment reviews.
total cost savings
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Let’s talk about modernizing your business.
There’s no shortage of ways we can help. Get a conversation going with one of our Solution Advisors and build a thoughtful approach aligned to your business goals.