Zelis Launches Solution for Out-of-Network Health Bill Payments

Healthcare technology company Zelis debuted an out-of-network payments solution.

Health Bill Assist lets payers support plan members with out-of-network health bills at no cost to members, according to a Monday (Sept. 9) press release.

“Out-of-network billing is not only confusing and frustrating for members, but the process of handling out-of-network claims, member appeals and provider negotiations adds [a] significant administrative burden to health plans,” Zelis President of Price Optimization Jay Deady said in the release. “We are proud to provide a level of support not readily available in the market today, helping health plans explain and mitigate these costs effectively.”

Health Bill Assist is designed to improve plan members’ healthcare financial literacy, spot and resolve billing discrepancies, and use Zelis’ team of expert negotiators to settle bills with providers when appropriate, per the release.

A Zelis study showed that many consumers face challenges in paying for healthcare, and those who struggle to pay medical bills often face repeated instances of financial strain, according to the release.

Similarly, the PYMNTS Intelligence report “The Digital Platform Promise: How Patients Want to Streamline Healthcare Payments” found that 21% of consumers encountered at least some trouble when paying for their healthcare. The study also revealed that 16% said insurance covered less than anticipated.

Some demographics may be particularly vulnerable if the range of payment options, including cards and payment plans, is narrowed down. According to PYMNTS Intelligence’s 2024 Women’s Wellness Index, nearly a quarter of women who struggle to pay monthly expenses said medical bills are a primary reason for distress.

“That’s why collaboration is critical,” the release said. “In addition to enhancing the overall value and support provided to members, it leads to a better understanding of financial outcomes and a stronger member experience.”

In other healthcare payments news, Banyan President Alpesh Chokshi told PYMNTS this week about a new collaboration between loyalty program Bilt Rewards and Walgreens — underpinned by Banyan’s platform and receipt-level data.

The partnership can help eliminate the friction and waste surrounding flexible spending accounts (FSAs) and healthcare savings accounts (HSAs).

“Consumers get greater convenience and savings on the healthcare-related items they need; Bilt and payment cards gain increased spend engagement; and Walgreens boosts its sales and customer experience,” the report said.