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Health care industry

Zelis Launches Intelligent Pricing Platform to Simplify Complex Claims Workflows

Strategic Insights

— 1 min read

Zelis, a leading healthcare technology solutions provider, has launched the Zelis Intelligent Pricing Platform (ZIPP) to optimize claims workflow and reduce administrative burden for health plans. The platform integrates intelligent claims routing and human expertise to deliver faster and more accurate claims outcomes. Health plans are under pressure to unify fragmented claims workflows, reduce administrative burden, and deliver measurable ROI while minimizing friction with providers and members. Zelis' State of the Healthcare Financial Experience report highlights the challenges faced by payers, with 77% believing that delivering healthcare is not getting easier, citing rising costs, technology fragmentation, and administrative complexity as primary challenges.

Key Takeaways:

  • ZIPP is a unified, end-to-end cost containment solution designed to optimize every claim for coding accuracy, savings recommendations, and compliance.
  • The platform offers a unified architecture, modular flexibility, AI-powered expertise, and compounding value, enabling smarter, faster, and more transparent decisions across the claims lifecycle.
  • ZIPP has been trusted by hundreds of payers delivering over $8 billion in claims savings, with a team of over 1,600 years of combined expertise supporting its hybrid model.
  • The platform has reduced system complexity, streamlines operations, and drives measurable impact across the healthcare ecosystem.
  • ZIPP is a direct response to the complexity and fragmentation that's holding healthcare back, and is a modernization of the financial experience of healthcare.
  • Zelis has decades of experience in claims pricing and payment integrity, pricing over $155 billion in claims annually.

Statistics:

  • 77% of payers believe delivering healthcare is not getting easier, citing rising costs (33%), technology fragmentation (31%), and administrative complexity (30%) as primary challenges.
  • 96% of payers use multiple solutions for payment integrity.
  • Only 23% of health plans are actively using AI to improve payment integrity.
  • ZIPP has processed over $8 billion in claims savings for hundreds of payers.
  • Zelis has priced over $155 billion in claims annually.

Sources:

  • Businesswire.com: https://www.businesswire.com/news/home/20251029007492/en/
  • State of the Healthcare Financial Experience report by Zelis (no date provided)
  • Zelis.com (no date provided)
  • LinkedIn (no date provided)

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