Utilizing Pre-Payment Auditing to Maximize Savings and Reduce Abrasion

Tuesday, 11/16/2021
11:00 AM CT – 12:00 PM CT (60 minutes)
Vendor Spotlight Host: Zelis

This vendor spotlight is hosted on our BigMarker platform you must use Google Chrome or Firefox when participating in the webinar.

 

Stemming the financial impact and proliferation of high-dollar claims remains a universal challenge for health plans today. While a key tenet for most plans is to assure the viability of care, all too often, they overlook the rigor necessary to manage the billing discipline behind complex, high-dollar claims effectively.

During this webinar, participants will learn:

 

• The value of pre-payment audit and its impact on savings and minimized provider abrasion.
• Practices to ensure that your pre-payment bill review process captures every dime in savings from coding errors and inappropriate charges.
• Ensure accuracy of payment through Hospital Bill Review services, including Itemized Bill Review and Clinical Chart Review of inpatient and outpatient facility claims.
• Why maximizing the power of coding expertise and clinical oversight together as a singular solution can generate immediate savings opportunities.
• The value that the Cox Health team realized by selecting a bill review partner to implement pre-payment bill review.

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About Zelis

 

Zelis is a healthcare and financial technology growth company and market-leading provider of claims cost management and payments optimization solutions to price, pay and explain healthcare claims. Zelis delivers integrated network analytics, network solutions, payment integrity, electronic payments and claims communications for payers, healthcare providers and consumers in the medical, dental and workers’ compensation markets nationwide. Zelis is backed by Parthenon Capital Partners and Bain Capital. Zelis is headquartered in Bedminster, NJ with other key locations in Atlanta, GA; Clearwater, FL; Overland Park, KS and St. Louis, MO.

Zelis’ mission is to generate the lowest, most accurate total claim cost, through better upfront network design and pricing, an embedded post adjudicated pre-payment suite of technologies that are supported by highly trained professionals to deliver direct and indirect savings along the claim lifecycle. Concluding the claim lifecycle process Zelis provides settlement and disbursement of funds to the provider community through our electronic provider payment network as well as delivering clear consolidated member communications.

More than 85% of the time, we identify additional network cost, claims cost, payments and communications cost savings other companies are unable to find. That’s because we’re more than 1,000 people working as one with payers and providers to deliver industry-leading levels of service and performance. Every network. Every claim. Every payment. Every communication. Every day.

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Notice to Participants:
Please note that this webinar is a Vendor Spotlight and will be a capabilities-focused presentation. While this vendor is not under contract with the Health Plan Alliance, we believe this webinar will provide you the opportunity to learn more about this vendor and the programs and services it provides. Offering this webinar does not imply that the Health Plan Alliance endorses this vendor. The webinar is merely for informational purposes only. Should you wish to share feedback and/or have questions about this vendor, please contact Jaime González, the Alliance’s Chief Business Development Officer, at jaime.gonzalez@healthplanalliance.org or 972-830-6355.

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