How One Payer Used Market-Based Pricing to Drive Out-of-Network Savings
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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Zelis Expert Claims Review®
Uncover coding errors and inappropriate charges with expert pre- and post-payment claims review.
Human Expertise and Advanced Technology ─ on Every Complex Claim
Itemized bill review
Line-by-line review of complex claims to find coding and billing errors that drive overpayments.
High-cost drug review
Clinical review of medication claims billed through medical drug benefits.
DRG validation
Clinical and coding review to ensure correct DRG assignment and adherence to coding standards.
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Better Outcomes Before IDR: A TPA Case Study in NSA Performance
Explore how to use AI and automation improve healthcare claims management and how collaborating with experts can help.
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Proven Savings with SmartShopper
Discover the findings of the Wakely report, highlighting savings of $552 through SmartShopper participation and care transparency.
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Claims Review Resources
Healthcare Fraud, Waste and Abuse Guide
Learn what fraud, waste and abuse mean in healthcare, how to spot FWA indicators, and how payers can reduce improper payments with stronger payment integrity.
Reimagining P&C Claims Performance Webinar
Learn how P&C insurers can modernize medical payments, reduce manual work, accelerate claims workflows and improve claimant and provider experiences.
Everest Group 2026 Pre-Payment Integrity Report
Download Everest Group’s 2026 Pre-Payment Integrity PEAK Matrix report to see why Zelis was named a Leader for prevention-first payment accuracy for payers.
