Simple Claims Adjudication
Malike once dreaded claims adjudication. Each claim required completing arduous tasks like verifying claim eligibility, checking past payment histories, and cross-referencing network discounts. Malike found adjudication a labor-intensive process fraught with challenges exacerbated by an ever-evolving environment of provider networks, discount plans, and regulation. Malike knew better methods existed but assumed his organization’s infrastructure limited options to optimize workflows.
Enhancing User Experiences
Remove obstacles and empower action
Removing unnecessary paper records from the healthcare financial chain offers numerous advantages. From reduced overhead to better data security, paperless record keeping is a boon for trimming operations costs while improving user value. Let Zelis guide your platform to peak optimization with a suite of APIs that improve operational efficiency.
Use Case Featured APIs
- Price Optimization QuickReprice
Zelis APIs
Optimizing daily operations
Or so he thought. When Malike’s organization integrated Zelis’s Price Optimization QuickReprice API, his opinion of claims management significantly improved. The QuickReprice tool uses innovative technologies, backed by industry experts, to clear common obstacles with claim adjudication and management. Zelis takes on the challenging work of incorporating CMS and AMA’s latest industry technology updates, ensuring maximum capture of savings opportunities.
Accuracy brings peace of mind
Malike is also confident in the tool’s accuracy. He knows Price Optimization QuickReprice reviews all claim lines against patient and provider histories. Plus, Zelis’s post-adjudication, pre-payment interface utilizes Ebix Health support, is built with LuminX, and is backed up by Zelis’s latest industry data and trend analytics.
Full support and custom configuration
The Zelis QuickReprice API offers providers a precision claims management tool optimized for accuracy and enhancing savings opportunities with customization options for your operations. Zelis’s dedicated team can configure all Payor customizations, like plan policy, medical policy, and provider contracts, to streamline integration.
