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Solutions / Payment Integrity

Payment Integrity

Ensure the accuracy and integrity of claims – before you pay.

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Payment Integrity Suite

Maximize savings by minimizing costly claim and billing errors.

  • Gain efficiency with a single point of contact for Payment Integrity solutions
  • Customize options, reports and rules
  • Use analytics for precise pre-payment claim review
  • Maximize savings on every claim
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Bill Review

We use itemized bill and advanced clinical chart audits prior to payment to uncover coding errors and inappropriate charges.

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Claims Editing

We incorporate technology, analytics and clinical expertise to identify billing and coding accuracy. Zelis uses client-specific customizations to align with each plan’s unique medical, benefit, and payment policies.

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Case Study

Third-Party Administrator ACS Benefit Services realizes $13M in Savings

By choosing to add Zelis as their external partner for healthcare bill reviews, edits, and audits, ACS has converted more than 300,000 paper payments to electronic modalities and realized $13M in gross savings since 2018.

Take the Next Step

See how much you can save with a Payment Integrity impact analysis.

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