Zelis® Intelligent Pricing Platform℠ Unifies Payment Integrity and Claims Pricing Capabilities for Payers

Integrated platform applies intelligent claims routing and human expertise to deliver smarter, faster, and more accurate claims outcomes

BOSTON--(BUSINESS WIRE)--Zelis®, a leading provider of healthcare technology solutions, today announced the launch of the Zelis Intelligent Pricing Platform^SM (ZIPP)—a unified, end-to-end cost containment solution designed to optimize every claim for coding accuracy, savings recommendations, and compliance.

Health plans face mounting pressure to unify fragmented claims workflows, reduce administrative burden, and deliver measurable ROI while minimizing friction with providers and members. In fact, recent findings from Zelis’ State of the Healthcare Financial Experience report show that:

• 77% of payers believe delivering healthcare is not getting easier, with rising costs (33%), technology fragmentation (31%), and administrative complexity (30%) cited 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

"As healthcare costs continue to rise, payers are putting greater focus on optimizing their cost containment strategies while maintaining healthy relationships with their providers and members,” says Mark Allphin, KLAS Research. “Payers are looking to consolidate vendors where possible and get maximum benefit from integrated payment integrity and pricing capabilities - which is where we see a shift to platforms vs. point solutions accelerating as a way to enable smarter, more defensible outcomes.”

ZIPP offers payers one platform, one partner, and one connected experience—eliminating the complexity of managing multiple vendors and empowering smarter, faster, and more transparent decisions across the claims lifecycle.

A New Era for Claims Optimization

ZIPP is more than a platform—it’s a strategic hub that harmonizes scalable automation with expert human oversight. Claims are seamlessly ingested, intelligently routed, and reviewed across multiple solutions, compounding insights and savings while reducing friction, complexity and administrative burden.

Key Benefits of ZIPP

• Unified Architecture: ZIPP replaces siloed systems with a single, integrated platform—streamlining operations and delivering full lifecycle visibility for every claim.
• Modular Flexibility: Health plans can start small and scale fast, activating only the modules they need—such as claims editing, pricing, or itemized bill reviews —without disruptive system overhauls.
• AI-Powered, Expert-Led: ZIPP blends automation with human insight. AI accelerates claim ingestion, routing, and error detection, while Zelis experts validate decisions for compliance and defensibility.
• Compounding Value: The more ZIPP capabilities activated, the greater the impact. Integrated analytics grow smarter with every claim processed, enabling longitudinal insights and proactive compliance.
• Unified Client Portal: Clients no longer have to swivel between disparate portals and disconnected insights.

Zelis has decades of experience in claims pricing and payment integrity, pricing over $155 billion in claims annually. In the past year, ZIPP’s capabilities have been trusted by hundreds of payers delivering more than $8 billion in claims savings. The platform’s hybrid model ensures every decision is transparent and tailored to payer needs—supported by a team with over 1,600 years of combined expertise.

“ZIPP is a direct response to the complexity and fragmentation that’s holding healthcare back,” said Serkan Kutan, Chief Technology Officer, Price Optimization at Zelis. “With rising costs, disconnected systems, and mounting pressure to deliver ROI, payers need more than incremental fixes. ZIPP delivers a smarter, faster, and more accurate way forward. It’s how Zelis is modernizing the financial experience of healthcare, one claim at a time.”

Learn more about the Zelis Intelligent Pricing Platform and how it reduces system complexity, streamlines operations, and drives measurable impact across the healthcare ecosystem.

About Zelis

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

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