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What is Zelis?

Build, enhance, maintain, and promote your network using a cohesive platform that integrates all necessary functionalities. Leverage competitive intelligence to strengthen your position in the market effectively. Streamline and standardize provider information to make searches more user-friendly. Assess network performance through key metrics such as accessibility, cost, and quality. Offer engaging and feature-rich solutions that enhance the provider search experience. Develop a more profound understanding of your network's financial performance. Create and refine networks that are not only competitive and accessible but also deliver superior value to attract market share and address your members' needs. Keep an eye on competitor strategies and market trends to refine your network approach, identify the best providers for maintaining competitiveness, and highlight the strengths of your network. Simplify the management of your provider directory, plan design, and benefit consulting by utilizing faster and more reliable provider network data. Tailor networks to align with each client's unique goals, risk preferences, and desired provider access, ensuring a holistic approach to network governance. This comprehensive array of features not only boosts operational efficiency but also reinforces your market standing, ultimately leading to sustained growth and innovation. With such a robust platform, you can confidently navigate the complexities of network management while focusing on delivering value to your clients.

What is HealthRules Payer?

HealthRules® Payer is a state-of-the-art core administrative processing framework that delivers transformative capabilities for health plans of all shapes and sizes. For more than ten years, health plans that have adopted HealthRules Payer have successfully seized market opportunities and sustained a competitive advantage. What distinguishes HealthRules Payer from other core administrative systems is its unique utilization of the patented HealthRules Language™, which closely resembles English and introduces an innovative approach to configuration, claims management, and transparency of information. This exceptional system empowers health plans to grow, innovate, and excel beyond their competitors more efficiently than any other core solution currently available. Consequently, HealthRules Payer not only enhances operational efficiency but also cultivates a culture of adaptability and responsiveness within health organizations, ultimately leading to improved patient care and satisfaction. By integrating advanced tools and methodologies, HealthRules Payer positions health plans to thrive in an ever-evolving healthcare landscape.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Zelis

Date Founded

2016

Company Location

United States

Company Website

www.zelis.com

Company Facts

Organization Name

HealthEdge Software

Company Website

www.healthedge.com

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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