Zelis®, a leading provider of healthcare technology solutions, has announced an expanded approach to member communications. The approach makes healthcare financial information easier for members to understand and use. The company is giving health plans greater financial context around claims, payments and benefits. As a result, members can better understand their healthcare experiences and take appropriate action.
Zelis integrates healthcare financial information with payment and multi-channel communication workflows. This connection makes for more continuity across the financial journey. It also allows health plans to provide more clear information at key moments of member interaction. A challenge continues for healthcare organizations, according to research from Zelis and Datos Insights. The research reveals a gap between how important financial clarity is and how well it is being communicated.
Only 21% of health plans that say that Explanation of Benefits (EOB) clarity is extremely important say they are very effective at delivering that clarity. So the gap is larger as healthcare affordability continues to be a concern for members. Members need clear information on their coverage and healthcare costs. They also need to grasp the financial ramifications of their treatment.
But sometimes the language used in claims and billing can be difficult to understand. Members may thus have more frequent contact with service teams. They can also create billing disputes or delay payments. These challenges can add to members’ financial stress. At the same time, they can add administrative work and expense to health plans.
“Members should not have to piece together what happened, what was covered, what they may owe and what to do next,” said Yusuf Qasim, President of Payments at Zelis. “Clear communication starts with preserving the healthcare and financial context behind it. Zelis has a unique opportunity to connect that context with the communications members receive, helping health plans make complex financial interactions easier to understand and act on.”
Connecting Healthcare Financial Information Across the Journey
Zelis operates across the healthcare financial journey. The company connects with systems and workflows where claims, payments and clinical information originate. This integrated insight helps Zelis preserve information meaning and accuracy. The information remains connected as it moves through different healthcare processes. The process begins with claims processing and adjudication. It then continues through payment workflows and reaches the member.
Zelis supports member communications through four connected areas. Together, these areas help health plans maintain greater consistency and control.
- Healthcare transaction context: Zelis provides visibility across claims logic, payments and post-adjudication workflows. This consistency helps preserve the meaning behind information shared with members.
- Complete transparency and control:Zelis connects data, processes and communication workflows. This enables health plans to reduce fragmentation and avoid unnecessary handoffs.
- Health care capability:Industry-specific knowledge is a great help with compliance in print and digital communication channels.
- Operations scale and resilience:The member communication is complex and driven by both physical and digital infrastructure. And it helps scale time-sensitive communications, too.
Zelis Expands Member Communications Infrastructure
Zelis is also expanding its physical infrastructure to support multi-channel communications. The company is opening a new company-operated production facility in Phoenix, Arizona. The Phoenix facility joins an existing Zelis operation in St. Louis, Missouri. Together, the two locations create additional production capacity.
The two-site model also offers geographic redundancy and increased routing flexibility. These capabilities can support time-sensitive, high-volume member communications. The communications include ID cards, Explanation of Benefits documents, letters and notices. Demand could spike during periods such as annual enrollment. So operational capacity is crucial to be able to maintain reliable member communications.
“The new Phoenix facility strengthens the operational foundation behind the member experience,” Qasim said. “Scale and resiliency matter, but they are most valuable when paired with an understanding of the healthcare information being communicated. Zelis brings those pieces together—the claims and payment context, healthcare expertise and communications infrastructure—so health plans can make complex information clearer for the members they serve.”
Zelis Member Communications capabilities cover both physical and digital communications. The company also supports price transparency and member navigation. These solutions support other member-facing healthcare needs as well. Overall, Zelis provides these capabilities for 71 million health plan members.
Through its connected approach, Zelis aims to help health plans communicate complex financial information more clearly. The company combines healthcare expertise, financial context and communication infrastructure. This approach connects important information across the healthcare financial journey. It also gives health plans tools to support clearer and more actionable member experiences.
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News Source: Businesswire.com
