Zelis Intelligent Pricing Platform℠
One platform to optimize every claim, simplify operations, maximize savings and deliver measurable results – without the friction or administrative burden.
What is the Zelis Intelligent Pricing Platform?
Zelis Intelligent Pricing Platform (ZIPP) is a modular, end-to-end ecosystem that unifies claims pricing and payment integrity into a single, seamless experience. Powered by advanced AI and expert human oversight, ZIPP intelligently routes and reviews every claim—optimizing for accuracy, savings, and compliance.
How does ZIPP transform cost containment? Here are five ways:
- Replace vendor sprawl with a single platform that connects pricing and payment integrity workflows.
- Seamless integration with existing systems and adjudication platforms.
- Start small and scale fast—activate solutions at your pace.
- We intelligently route your claims through multiple solutions, optimizing every touch for accuracy and savings.
Explore Zelis Payment Integrity Solutions
- AI that’s trained for defensible payment accuracy.
- Outcomes validated by Zelis experts.
- The more platform solutions you use, the greater the accuracy, savings, and operational efficiency.
- Eliminate the need to update claims across disparate systems and portals.
- Real-time dashboards and analytics deliver transparency.
How does ZIPP work?
One Claim. One Platform. Every Opportunity Maximized.
- Submit your claim through a single ingestion point — ZIPP does the rest. Leveraging our Intelligent Claims Routing Platform®, claims are assessed and routed to the right solution and review channel for optimal accuracy and savings.
- AI flags errors and savings opportunities, while experts review and validate outcomes.
- Track every claim’s journey in a unified, auditable portal—no more bouncing between systems or vendors.
Proven Results
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payers served
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claims processed
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claims volume
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retention of savings priced
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of disputes held
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years of combined expert tenure
*based 2024 data
Supporting Health Plans, Providers and Members Across the Healthcare Financial Journey
ZIPP is more than technology—it’s supported by wraparound services that help members and providers navigate the complexity of healthcare billing and payments. Zelis works across the ecosystem to ensure all stakeholders have visibility and support, leading to a better, less abrasive healthcare financial experience.
Frequently Asked Questions
Yes. ZIPP is configurable, allowing you to turn on the solutions you need as you need them with minimal lift and implementation burden. Additionally, each solution can be tailored to accommodate payer contracts, policies and more down to the TIN level.
We have significant experience in integrating with client core administration and adjudication systems, having developed hundreds interfaces to efficiently deliver our solutions.
With ZIPP you choose which payment integrity or pricing solutions you want to turn on. Start small or scale fast, either way, our unified architecture and approach are built for minimal IT and implementation burden.
We use HITRUST security framework, which leverages NIST, ISO, and HIPAA security standards.
We build our edits using gold-standard sources (such as the American Medical Association (AMA), American Heart Association (AHA), International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), World Health Organization (WHO), Centers for Medicare & Medicaid Services (CMS), Federal Drug Administration (FDA), InterQual, Medicare Milliman Clinical Guidelines (MCG), and additional payer guidelines and payment policies). While AI helps route claims, our team of clinical experts review outcomes for accuracy and defensibility.
AI powers faster claim ingestion, automated routing, and error detection in claims management.
ZIPP provides real-time dashboards across all payment integrity and claims pricing modules, giving you full visibility into claims editing, savings, and operational performance.
Request a Meeting
Ready to simplify cost containment and optimize every claim?
Experience the Zelis difference.
Unify your claims pricing and payment integrity with ZIPP—one platform, one partner, one flow, every claim optimized.
