Zelis

Zelis's Regulatory Compliance

Zelis ensures adherence to crucial regulatory requirements, including those specified by the National Security Agency (NSA) and Transparency in Coverage (TiC) rules. This compliance is essential for maintaining the trust of its clients and for the seamless operation of its services. By aligning with these regulations, Zelis guarantees that its solutions are not only effective but also legally sound, ensuring data security and transparency in healthcare transactions.

Zelis's Out-of-Network Solutions

Zelis provides innovative out-of-network solutions designed to uncover significant savings for its clients. These solutions help organizations manage expenses associated with out-of-network claims, which can often be unpredictable and costly. By leveraging advanced analytics and negotiation strategies, Zelis helps clients achieve substantial cost reductions while maintaining quality care for their members.

Zelis's Payment Integrity Solutions

Zelis offers comprehensive payment integrity solutions aimed at capturing savings on every claim before payment. These solutions scrutinize claims to identify inaccuracies, inefficiencies, and potential fraud, ensuring that only accurate and justified payments are made. This proactive approach not only reduces unnecessary expenditures but also enhances the overall financial health of healthcare organizations.

Zelis's Network Solutions

Zelis provides robust network solutions that assist in building, optimizing, maintaining, and selling high-performing healthcare networks. These solutions are designed to enhance network performance, ensuring that providers and payers can deliver and access care effectively. By optimizing network configurations and leveraging data-driven insights, Zelis helps its clients achieve operational efficiency and improved patient outcomes.

Zelis's Member Engagement Solutions

Zelis offers member engagement solutions that empower members to navigate their healthcare options and find affordable care. These solutions provide members with the tools and information they need to make informed decisions about their healthcare, leading to better health outcomes and cost savings. Through enhanced communication and support, Zelis ensures that members are actively engaged in their care journey.

Zelis's Connected Platform

Zelis employs a connected platform that bridges gaps in the healthcare financial system. This integrated approach connects various stakeholders, including payers, providers, and members, facilitating seamless transactions and communication. The platform enhances efficiency, reduces administrative burdens, and streamlines financial processes, ultimately contributing to a more cohesive and effective healthcare ecosystem.