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Guide Members to Lower-Cost Care Before Decisions Are Made
Empower Smarter Member Decisions
Talk to an expert and find out how to empower members with the tools, guidance and transparency they need to make informed care decisions while lowering unnecessary healthcare spend.
Address the Barriers to Smarter Care Decisions
Many health plans struggle to influence member behavior due to limited engagement, disconnected experiences and fragmented healthcare navigation tools.
Without a connected strategy, members may lack the support and information needed to make cost-conscious healthcare decisions before care is delivered.
Common Challenges:
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Limited Visibility Into Provider Costs: Members often struggle to compare healthcare costs and identify high-value care options.
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Low Adoption of Transparency Tools: Existing transparency solutions frequently experience low utilization and inconsistent engagement.
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Fragmented Member Experiences: Disconnected tools and vendors create friction across the healthcare journey.
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Inefficient Vendor Ecosystems: Managing multiple point solutions can increase operational complexity and reduce effectiveness.
Connect Engagement, Transparency, and Navigation in One Platform
Zelis helps health plans improve member decision-making through a connected platform that combines transparency, incentives, navigation and engagement capabilities into one streamlined experience.
This integrated approach helps plans influence decisions earlier, improve engagement, and reduce unnecessary healthcare costs.
Guide Members to Lower-Cost Care in Four Steps
Manage the full lifecycle of healthcare payments — from reimbursement to communications — with flexible, scalable infrastructure.
Capabilities:
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Provider Payments: Streamline reimbursement with modern payment delivery, improved transparency and tools that drive digital adoption at scale
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Member Disbursements: Deliver fast, secure payments across digital and traditional channels
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Premium Payments: Support premium collection with flexible payment options and streamlined workflows
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Unified Payments & Communications: Manage claims payments, remittance and payment communications in a single system
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Flexible Payment Orchestration: Configure workflows based on provider preferences, payment rules and business needs
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Modern, Scalable Architecture: Integrate with existing systems and scale without costly rebuilds
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Intelligent Payments Communication: Streamline EOBs and other payment communications across channels.
A More Effective Approach to Member Engagement
Zelis combines multiple capabilities into one connected platform, helping health plans move beyond fragmented tools and drive more consistent engagement and cost-saving outcomes.
Key Benefits
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Unified Platform: Integrated capabilities across search, transparency, incentives and navigation.
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Proven Cost Savings: Solutions designed to reduce total cost of care while improving member decision-making.
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Built for Healthcare: Purpose-built for health plans, payers and TPAs.
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Flexible Integration: Works alongside existing systems and operational workflows.
Deliver Measurable Cost Savings
Zelis solutions are designed to create real financial impact through improved member decision-making and connected engagement experiences.
80%+
Plan member utilization
90 NPS
SmartShopper satisfaction score
3.3:1
Average ROI achieved
750+
Payers supported nationwide
$82M
Program savings for plan sponsors
70M+
Members supported nationwide
Start Reducing Costs and Improving Member Decisions
Help members choose high-value care while lowering total cost of care for your health plan through a connected engagement strategy.