Zelis will collect, aggregate and analyze claims settlement and arbitration data to develop a predictive model that illustrates the overall effectiveness of pricing and arbitration results, and . Explore our library of content crafted to empower you in making healthcare work better. Payments Optimization for Providers. And counting. Post author: Post published: February 14, 2022 Post category: cro conferences 2021 near bergen Post comments: united states peace index united states peace index Please contact Smart Data Solution Support line at 855-297-4436 to establish a direct connection. Get paid up to 20 days faster with Zelis ACH. For this article, I sat down with Kelly Romsdahl, Zelis Director of Content, to discuss the ways in which content development and maintenance build stronger relationships within a claims review and payment workflow and promote more harmony across healthcare payments. 10 free leads on us . Member Services. Contact information by category. Coverage, Claims, and Medicare Information Find phone numbers for plan and coverage questions, claims mailing addresses, and more. Build, optimize, maintain, and sell performing networks. Thanks to our teams agility, this code was added to the content in the edit and was live within Zelis Claims Editing suite by April 12. . www.zelis.com All Medical Claims; Benefits, Claim Services; Pre-Notification; Billing & Cancellation; . Support. All licensed health care providers are accepted. Contact Us Regarding An Existing Claim For information about an existing claim or to speak with someone regarding your claim: Phone: 800-233-8931 Email: overlandparkincoming@esis.com For more information on filing a new claim: Phone: 866-789-3747 Fax: 866-300-8206 Email: esisclaims@tnwinc.com Website: www.netclaim.net Medical, Dental, Vision Phone Number 1 (800) 244-6224 24 hours a day, 365 days a year Medical Claims Cigna PO Box 182223 Chattanooga, TN 37422-7223 Dental Claims Cigna PO Box 188037 Chattanooga, TN 37422-7223 A huge benefit is the ability to customize edits for specific services. Bonnie Coburn is the Vice President of Product for Claims Editing at Zelis. At Zelis, Bonnie is part of the team building comprehensive payment integrity solutions for our clients. Explore our library of content crafted to empower you in making healthcare work better. The content team that Kelly oversees works closely with the Office of the CMO to ensure edits are sourced, referenced, and regulatory and/or especially society coding guidelines supported. The second component is content, which is the clinical and regulatory source code data that supports edits and serves as the foundation of and logic for triggering the edit. Refer to the patient's ID card for details. Zelis Claims Integrity, LLC was registered on Apr 06 2018 as a foreign limited liability company type with the address 2 Concourse Parkway, Suite 300, Atlanta, GA, 30328, USA. Access Telemedicine and other services or speak to our Member Services team. The company id for this entity is 18060304. Discover who we are, what we value, and how we work at Zelis. 744 Office Pkwy. 5.1 Final Words; 6 FAQs. We accomplish this in a seamless manner with twice weekly content updates. Your patient's plan may include a pre-notification requirement for services, including hospitalizations, other inpatient care, inpatient surgeries or surgical procedures and outpatient IV infusion therapy, radiation therapy and cardiac surgery. Build, optimize, maintain, and sell performing networks. zelis provider phone number. Business Incorporated: Just visit. 18167 US Highway 19 North Suite 300 Clearwater, FL 33764 877-828-8770 . By working with Zelis, providers get access to these networks and gain exposure to more than 100 million patients nationwide, placement in provider directories of more than 700 payers, fair reimbursements and more. The company features enrollment and claims communications, primary and supplemental networks, enrollment communications, market-based pricing, etc. Limited Liability Company. 1.833.3-Altrua (258782) Meet regulatory requirements for No Surprises Act & Transparency in Coverage. This data consists of several different code sets, such as procedure codes, diagnosis codes, modifiers, revenue codes, and type of bill codes. To say that healthcare billing is complex would be an understatement. This includes conducting end-user testing to ensure client workflows are not disrupted when a new edit is activated. Uncover significant savings with a layered approach. Agent Address. Cigna handles the administrative burden to help health care providers handle prior authorizations, claims, appeals, and more. Capture savings on every claim before you pay. Zelis Claims Integrity, Inc is a firm that provides administrative support, insurance agent or broker, and consulting services to nonprofit clients. We work with Zelis from pre-payment through sending the payment., They have excelled at finding large dollar overpayments that have enabled us to exceed our goals.. Zelis is a healthcare and financial technology company and market-leading provider of claims cost and payments optimization solutions to price, pay and explain healthcare claims to more than 700 payers and 1.5 million providers nationwide. 24 September 2001 (almost 21 years ago) Company Type. Contact the pre-notification line at 866-317-5273. If you're unable to determine the claim administrator for an employer group, call our Customer Service Contact Center at 1-800-824-7406 for assistance. Benefits, Coverage or Claims Repricing. There you will find enrollment and claims information (including copies of Explanations of Benefits) and the ability to track claims. To learn more about Zelis Claims Editing, please contact us! Medical claims can be sent to: Insurance Benefit Administrators, c/o Zelis, Box 247, Alpharetta, GA, 30009-0247; EDI Payor ID: 07689. When anyone attempts to solve a complex challenge, it is best to have multiple participants and functions participating in solution design. The 2022 Payment Harmonization Index is here. Discover who we are, what we value, and how we work at Zelis. We are here to answer your questions and verify your patient's benefits and account status, as well as to provide claim status updates. Additionally, the Zelis content team goes one level deeper to apply a source and reference to every code data relationship in our product (not just at the edit level), which, in turn, supports defensibility and provider education. 1 (800) 88CIGNA (882-4462) Behavioral. Phone Email. Customizable Edits Customizations and edit optimization ensure your edit rules are staying up-to-date with regulatory changes, in-house policies, and unique provider contracts. If you have any questions or would like more information about participating in a Cigna health care network, please contact us. Contact medical providers to negotiate greatest discount/savings on out of network claims submitted to Zelis; Zelis simplifies administrative work so employees can focus their efforts more effectively. While its possible to have edits with this data hard coded within the logic, most often, content is maintained separately from edit logic. Meet regulatory requirements for No Surprises Act & Transparency in Coverage. Pharmacy. Insured Providers Self-Service Site Contact Contact Us. Build, optimize, maintain, and sell performing networks. Find contact information for Zelis. Creve Coeur. What is Zelis's phone number? Competitors. Zelis delivers integrated network analytics, network solutions, payment integrity, electronic payments and claims communications for payers, healthcare . Deliver faster payments and better communications to your clients. Team Members. Zelis Payments. In order to join, please email providercontact@zelis.com to request a network enrollment packet or contact the PPOplus Provider Services Department at 1-888-965-7718 to request an application for participation. Providers can access myPRES 24 hours a day, seven days a week. . Zelis represents one of the nation's largest combined member networks in the country, processing more than 13,000 patient encounters every hour. Brian Gladden. Our out-of-the box approach provides a flexible solution that ensures timely, accurate payments. How to register an account? 5 Zelis Helpdesk Contact Information. Discover what works best for your business: Zelis ACH With ACH, you get paid weeks faster than by mailed check. Whether you need a first-pass editor or a secondary one, Zelis Claims Editing fits in your workflow to ensure you are capturing the most savings possible. No more costly manual processes and workarounds. A lot of companies are talking about transforming the business of healthcare, but we're taking action. All Group/Policy numbers +. Most Zelis Claims Integrity, Inc clients are health and welfare funds with revenues ranging from $28 million to $414 million. You can contact us at 915-532-3778 ext. Benefits, Claims services - Check your ID Card for your plan's phone number. More than 700 payers rely on Zelis to price, pay and empower a better healthcare financial experience. Through the index study, we learned there is a lot of opportunity to promote harmony within the healthcare financial experience. For Questions About Benefits, Coverage, Or Eligibility: Contact the claim administrator at the phone number shown on the patient's ID card. Meet regulatory requirements for No Surprises Act & Transparency in Coverage. This is just one example of the importance of flexibility when it comes to releasing technology updates separate from content. Our total savings in just the past year topped $4.1 million resulting in $24.98 PEPM savings. Proactively identifying billing errors is proven to reduce overpayments and provider abrasion, all while improving savings. Being able to turn edits off and on by client or even apply them down to the provider level has assisted us immensely., Working with Zelis has helped us take an end-to-end approach to problems starting with pre-payment, looking at the best way to pay those claims initially to get the best pricing available. Regularly updated to adhere to national coding standards and enhanced by the Office of the CMO and a team of clinical experts, including physicians and nurses. A lot of companies are talking about transforming the business of healthcare, but we're taking action. If you have questions, please call our Customer Service Specialists anytime between 8 a.m. and 4:30 p.m. (CST) Monday through Friday at, You have 24-hour access to verification of your patient's benefits, claim status or coverage information. 570 Carillon Pkwy STE 500, Saint Petersburg, FL 33716-1343. Uncover significant savings with a layered approach. United States. Medical claims can be sent to: Insurance Benefit Administrators, c/o Zelis, Box 247, Alpharetta, GA, 30009-0247; EDI Payor ID: 07689 You will be contacted by Insurance Benefit Administrators regarding final pricing for the claims submitted in the weeks following submission. Print or download data in whichever format you prefer (835, CSV, XLS, or PDF). For help with benefits, prior authorization, claims issues and service access questions, please contact Medica Behavioral Health: Intake/Benefits: 1-800-848-8327; Rightfax: 1-855-454-8155.