Zelis Review - why 4.4 stars?

Shlomi Lavi

We publish unbiased reviews. Our opinions are our own and are not influenced by payments from advertisers. This content is reader-supported, which means if you leave your details with us we may earn a commission. Learn why ITQlick is free .

What is Zelis?

Zelis is a beacon of innovation in the healthcare information technology sector, dedicated to modernizing the healthcare financial experience. Established in 2016 and headquartered in Boston, MA, Zelis stands as a testament to the transformative power of technology in healthcare. It serves a diverse clientele, including healthcare payers, providers, and consumers across the medical, dental, and workers’ compensation fields.

The company’s mission is to streamline the business of healthcare, ensuring access to quality care at reasonable costs. This mission is propelled by Zelis’ commitment to creating purpose-built solutions that ignite operations and foster a positive impact on the healthcare system.

Features of Zelis:

1. Network Analytics and Access: Zelis provides comprehensive insights into healthcare networks, enabling clients to make informed decisions about care accessibility and cost management.
2. Claims Integrity: With a focus on accuracy and transparency, Zelis ensures that claims are processed with the utmost integrity, reducing the risk of errors and overpayments.
3. Electronic Payments: Zelis simplifies the payment process, offering electronic solutions that expedite transactions while maintaining security and compliance.

Since its inception, Zelis has been on a trajectory of growth and innovation. The company proudly boasts over 2,500 associates globally, with offices in key locations such as Boston, Atlanta, Morristown, Plano, St. Louis, St. Petersburg, and Hyderabad. These teams work collaboratively to tackle the biggest challenges in the business of healthcare, driven by a culture that values diversity, equity, and inclusion.

Zelis’ dynamic executive team, with deep experience across healthcare, technology, and financial sectors, leads the company forward. They are not just steering Zelis towards success; they are shaping the future of healthcare financial management.

In conclusion, Zelis is not just a company; it’s a movement towards a frictionless healthcare financial experience. It’s a place where technology meets empathy, where innovation drives efficiency, and where every stakeholder in the healthcare ecosystem can benefit from smarter, more transparent financial practices. As Zelis continues to grow and evolve, it remains steadfast in its vision to end friction in healthcare and make a lasting impact on the industry.

Who is it best for?

Zelis serves a broad range of customers within the healthcare industry, focusing on streamlining the financial aspects of healthcare for payers, providers, and consumers. The industries they serve include medical, dental, and workers’ compensation fields, among others.

Typical customers of Zelis include:

• Healthcare Payers: This includes insurance companies, managed care organizations, and third-party administrators (TPAs).
• Healthcare Providers: Hospitals, physician groups, and individual medical and dental practitioners.
• Healthcare Consumers: Patients who benefit indirectly through more efficient and transparent healthcare transactions.

Zelis is known to partner with over 700 payers, including the top-5 national health plans, Blues plans, regional health plans, TPAs, and self-insured employers. Additionally, they work with millions of providers and serve over one hundred million members, which showcases the extensive reach and trust Zelis has established in the healthcare payments space.

Companies that use Zelis are typically looking for solutions in medical billing, claims processing, bill review, and claims negotiations to deliver a high-quality experience for their customers. Zelis helps these companies optimize their entire healthcare payments lifecycle, ensuring a seamless experience for all parties involved.

Main features and functionalities

Here’s how Zelis can help:

1. Streamlined Payments: Zelis Payments is a medical billing software that simplifies the acceptance and tracking of payments. It’s designed to save time and reduce the administrative burden associated with financial transactions.

2. Data-Driven Insights: The platform provides robust analytics that can help you understand payment patterns and optimize your billing processes.

3. Integration: Zelis Payments can integrate with various practice and dental management systems, allowing for a seamless flow of data and reducing the need for manual entry.

4. Fraud Protection: With integrated fraud protection, Zelis helps keep your customers’ payments secure, safeguarding your business against potential financial threats.

5. Sustainability: By going paperless with Zelis, your business can contribute to environmental sustainability and appeal to the growing number of consumers who value eco-friendly practices.

6. Vendor Consolidation: Zelis offers network solutions that can help reduce costs and improve efficiency by consolidating multiple vendor relationships into one streamlined partnership.

7. Faster Provider Payments: By joining a Zelis network or enrolling for electronic payments, you can increase access to patients and improve the speed and accuracy of provider payments.

What is the actual cost?

Pros

• Comprehensive Solutions: Zelis offers a wide range of integrated healthcare payment solutions, including payment integrity, network optimization, and consumer engagement tools, providing a holistic approach to healthcare payment management that many competitors struggle to match.
• Advanced Technology: Zelis leverages cutting-edge technology such as machine learning and analytics to identify and prevent improper payments and fraud in real-time, giving it a competitive edge in accuracy and efficiency compared to some competitors who may rely on outdated systems.
• Customized Pricing: Zelis provides flexible pricing models tailored to the specific needs and scale of each client, offering cost-effective solutions that are customizable to accommodate varying budget constraints, unlike some competitors with rigid pricing structures.

Cons

• Vendor Size: Compared to some larger competitors, Zelis may have fewer resources and a smaller market presence, which could potentially limit its ability to scale and support larger healthcare organizations with complex needs.
• Brand Recognition: Zelis may not have the same level of brand recognition as some well-established competitors in the healthcare technology space, which could impact its ability to attract new clients and compete for market share.
• Implementation Complexity: Depending on the specific solutions required, the implementation process with Zelis may be more complex or require more customization compared to competitors who offer more standardized or off-the-shelf solutions, potentially leading to longer deployment times and higher implementation costs.

How it stacks up?

Frequently Asked Questions (FAQs)