Summary
This case study outlines the implementation and impact of the Zelis Health Bill Assist program, which aims to support members in navigating out-of-network health bills. The program was introduced by Professional Benefit Administrators (PBA) and a Kansas-based Third Party Administrator (TPA) to enhance member support and mitigate unexpected out-of-network costs. The case study details how the program provides negotiation expertise, resolution of billing issues, expert navigation services, proactive communication, and educational support. Members have access to a dedicated team that assists them in understanding their healthcare benefits and resolving complex billing scenarios. Feedback indicates that members have benefited from the program, gaining clarity and reducing financial burdens associated with out-of-network care. The case study emphasizes the collaborative efforts between Zelis and its clients to empower members and improve overall satisfaction through proactive support and education, ultimately aligning with the mission to enhance the healthcare experience.
