Zelis Claims Editing 

Dive into our curated claims editing content library.

 

By the Numbers 

Measurable savings on every claim.

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First pass savings rate

~17%

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Second pass savings rate

~13%

target

< 2% of Zelis claim edits are

reversed

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Playbook: A Tale of Two Payment Integrity Worlds

The claims process, in its entirety, is necessary to ensure accurate and complete reimbursement. But inefficiencies within the revenue cycle often lead to time-consuming rework, additional administrative burden, and delayed or lost revenue for providers and payers alike.  

This eBook explores the current inefficient payment integrity landscape, claims editing best practices to avoid denial, and how to navigate this environment by choosing the right payment integrity partner.

Get it here

Healthcare Claims Editing Content Explained: The Zelis Difference

Zelis Vice President of Product, Claims Editing Bonnie Coburn sat down with Kelly Romsdahl, Zelis Director of Content, to discuss the ways in which content development and maintenance build stronger relationships within a claims review and payment workflow and promote more harmony across healthcare payments.

Learn more
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Payment Integrity benchmark report- where do you stand?

 

Based on a survey of 214 healthcare payer executives, the Payment Harmonization Index was designed to establish the current state of engagement with members, identify gaps throughout the member experience, and explore the interdependence among payers, providers, and members.

This report is the second of five, highlighting findings from payment accuracy executives and offering an outline for the next wave of payment integrity and cost containment between payers and providers. Take the complimentary assessment specifically designed to evaluate where your organization is on the journey to payment integrity and see where you stand for 2024 planning.

Read the report
Take the assessment

Partnering to Establish a Holistic Payment Integrity Program 

Because each claim represents a unique patient story, a good payment integrity program must be holistic. 

An out-of-the-box approach to an efficient payment integrity program should have capabilities across five key areas: content, customization, communication, consulting, and collaboration.

Read the whitepaper
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“We knew we needed to work with a company that had an extensive out-of-network program, and because we were scaling our business, we needed to enhance claims editing support to optimize payment integrity, minimize waste, and pay claims as accurately as possible for our providers.”

– Chief Operating Officer at regional health plan