Zelis launches health bill assist to help members navigate out-of-network bills

Zelis' study found that many consumers have difficulty understanding their medical bills, with only a small portion reporting full comprehension. Health Bill Assist helps members decode out-of-network charges and offers assistance with their bills, easing financial stress. 

Health plans face high volumes of inquiries and claims, often stretching internal resources. Out-of-network billing requires specialised expertise in claim processing, negotiation, and healthcare regulations, which Zelis provides, allowing plans to focus on core functions. 

Providers spend significant time on billing disputes and negotiations, which delays payments and affects cash flow. By working directly with members and health plans, Zelis lightens the administrative load, enabling providers to focus on patient care. 

Education and Communication: members receive co-branded communications after claims are processed, along with access to educational resources and support to help them understand their bills. Experts explain claims processing, member rights under the No Surprises Act, and more. 

Investigation and Resolution: Zelis reviews bills for errors and discrepancies, working to correct claims and reduce member costs. Savings from these investigations have ranged from USD 100 to USD 7,000. 

Negotiation: when possible, Zelis negotiates with providers to lower members' out-of-pocket expenses, achieving reductions of 15% to 50%.