Zelis

July 14, 2026 Three years. Three steps forward. In 2026, Zelis advanced from Major Contender to Leader in the Everest Group Pre-Payment Integrity Solutions PEAK Matrix® Assessment. That climb isn’t luck. It’s proof that prevention-first works.

July 10, 2026 Recognition validates Zelis’ connected approach to payment integrity as payers accelerate the shift from retrospective recovery to pre-payment accuracy. Boston, M.A. — Zelis®, a leading provider of healthcare technology solutions, has been named a Leader in the Everest Group Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026. The timing reflects a meaningful shift in how health plans are approaching claims accuracy.

• Federal IDR volume continues to create pressure for both payers and providers. • Accurate QPA calculation, documentation and audit readiness are essential to defensible outcomes. • Open negotiation is one of the best opportunities to resolve disputes before they escalate. • Scalable NSA workflows can help reduce friction, manage costs and improve the member experience.

July 7, 2026 Brigid Dwyer, Director, Dental Solutions & Engagement According to Becker’s Dental Review, nearly 80% of dental practices have reported an increase in claim denials or payer scrutiny over the past 12 months. For Dental Support Organizations, that pressure can intensify quickly as they grow. One strong practice becomes two, and two can quickly become ten. And while that kind of growth is exciting, it can also reveal the parts of the business that weren’t built to scale.

• Zelis, a pioneer in pre-payment integrity, was named a Leader in Everest Group's Pre-payment Integrity Solutions PEAK Matrix® Assessment 2026 — up from Major Contender in 2025. • Zelis is innovating at a rapid pace to lead the market and independent analysts are taking note. • The market continues to shift from retrospective pay-and-chase recovery toward prevention to catch errors before claims are paid.

Unified No Surprises Act workflow helps payers reduce avoidable escalations, manage deadlines and improve visibility across the dispute lifecycle. Boston, M.A. — Zelis, a leading provider of healthcare technology solutions, today announces Zelis NSA Claim AdvantageSM, an AI-native solution designed to help health insurance payers manage rising Independent Dispute Resolution (IDR) complexity under the No Surprises Act (NSA).

June 6, 2026 Breaking Down the NSA Independent Dispute Resolution (IDR) Final Rule: What It Means for Payers On June 4, 2026, CMS published a final rule that keeps the basic open negotiation and IDR framework in place while adding new process, communication and administrative requirements for payers, issuers, TPAs and partners. CMS expects its enhanced IDR Gateway to become functional in stages over roughly 26 months.

June 8, 2026 As claims operations grow more complex and payers focus on pre-pay prevention, the right partner should help connect your strategy across the entire claim life cycle. Use this infographic to look beyond identified savings and pressure-test whether your payment integrity strategy is built to last.

Certification in consecutive years reflects Zelis’ continued investment in culture, professional growth, and associate wellbeing Boston, M.A. — Zelis, a leading provider of healthcare technology solutions, is certified as a Great Place to Work® in both the United States and India. In the U.S., Zelis earned the recognition for a fourth consecutive year, while Zelis India achieved certification for a third year in a row.

Executive Summary At first, they were reluctant to rely more heavily on market-based pricing recommendations as part of their out-of-network reimbursement strategy. Like many payers, they had concerns about provider abrasion and dispute rates. So instead of making a major change all at once, they took a gradual approach. The payer added Zelis’ Established Reimbursement Solution® (ERS) pricing recommendations to its ClaimPass® workflow over time. Later, they moved to a model that prioritized ERS.