Claims Insights

JSON twin: https://www.healthaidb.com/software/claims-insights.json

Company Name

Zelis

Product URL

https://www.zelis.com/claims-insights

Company URL

https://www.zelis.com

Categories

• financial Management
• revenue Cycle
• health Data Analytics
• healthcare Technology
• Revenue Cycle Management
• Analytics

Summary

Claims Insights by Zelis is a healthcare financial management tool that provides real-time payment data and analytics to enhance revenue cycle efficiency for providers.

Description

Claims Insights, powered by Rivet's financial diagnostic platform, offers providers actionable intelligence to visualize and act on payment insights. It enables identification of denial root causes, analysis of accounts receivable trends, and tracking of payment velocity across payer mixes through intuitive dashboards. This tool integrates data from over 550 payers, allowing for customized denial reports and process improvements to prevent future denials. It aims to transform the provider payments experience by delivering real-time, actionable intelligence, addressing revenue cycle challenges, and laying the foundation for future innovations in healthcare finance.

Api Available

yes

Certifications

• HITRUST Certification

Company Founding

2008

Company Offices

• United States

Compliance

• HIPAA
• HITECH
• SOC 2
• ISO 27001
• No Surprises Act
• Transparency in Coverage Rule

Customers

• Scripps
• Zelis Payments

Data Residency

US-only

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Real-time claims status tracking
• Automated data validation
• Streamlined claims submission
• Secure data exchange
• Flexible payment options
• Access to remittance data
• Historical data storage
• Integration with practice management systems

Id

SW2700

Integration Partners

• TriZetto Facets
• CareCloud Central
• InstaMed
• NaviNet Open

Integrations

• Facets
• QNXT
• HealthEdge
• Beacon/Spyglass
• WLT
• VBA
• Concentrix/Gias
• Illumifin
• Google Wallet
• Apple Wallet
• Zelle
• Availity

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• Advanced Explanation of Benefits (AEOBs)
• ID card capabilities
• Price transparency tools

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization

Product Code

SW2700

Product Name

Claims Insights

Ratings

• 3.9/5 (17 reviews) - G2
• 4.3/5 (17 reviews) - G2
• 2.7/5 (11 reviews) - G2
• 4.3/5 (13 reviews) - G2
• 4.0/5 (17 reviews) - G2

Regions Available

• United States

Related Urls

Release Year

2016

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA
• DLP

Specialties

• General Healthcare
• Revenue Cycle Management
• Payment Analytics

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• providers
• financial leaders
• administrative teams

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• The team is comprised of agile and tenacious people who are willing to take risks and make sure that their actions are consistent and effective.
• I have worked with Lorie P on getting multiple Tax IDs set up to get enrolled in Zelis Payments, and she makes the process so smooth and easy.
• Zelis representatives are quick to respond to your concerns. The representative Giovanna Dumbadse was so upbeat and knowledgeable about our choices and how the process worked.
• Haley has taken Scripps under her wing and has supported us with EFT registration. She is responsive and educated.
• I deeply resent this company for signing me up for services I do NOT want and forcing it on me against my will so that I have to spend two hours on the phone once a year reversing it.
• Zelis has a lot of great product offering. We appreciate their innovative ideas and solutions to the industry. Very impressive with the native wallet and super curious about the zchecks to come!

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Claims Insights",
  "company_name": "Zelis",
  "product_url": "https://www.zelis.com/claims-insights",
  "company_url": "https://www.zelis.com",
  "related_urls": [],
  "product_code": "SW2700",
  "summary": "Claims Insights by Zelis is a healthcare financial management tool that provides real-time payment data and analytics to enhance revenue cycle efficiency for providers.",
  "description": "Claims Insights, powered by Rivet's financial diagnostic platform, offers providers actionable intelligence to visualize and act on payment insights. It enables identification of denial root causes, analysis of accounts receivable trends, and tracking of payment velocity across payer mixes through intuitive dashboards. This tool integrates data from over 550 payers, allowing for customized denial reports and process improvements to prevent future denials. It aims to transform the provider payments experience by delivering real-time, actionable intelligence, addressing revenue cycle challenges, and laying the foundation for future innovations in healthcare finance.",
  "categories": [
    "financial Management",
    "revenue Cycle",
    "health Data Analytics",
    "healthcare Technology",
    "Financial Management",
    "Revenue Cycle Management",
    "Analytics",
    "Healthcare Technology"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "providers",
    "financial leaders",
    "administrative teams"
  ],
  "specialties": [
    "General Healthcare",
    "Revenue Cycle Management",
    "Payment Analytics"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2008",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Real-time claims status tracking",
    "Automated data validation",
    "Streamlined claims submission",
    "Secure data exchange",
    "Flexible payment options",
    "Access to remittance data",
    "Historical data storage",
    "Integration with practice management systems"
  ],
  "optional_modules": [
    "Advanced Explanation of Benefits (AEOBs)",
    "ID card capabilities",
    "Price transparency tools"
  ],
  "integrations": [
    "Facets",
    "QNXT",
    "HealthEdge",
    "Beacon/Spyglass",
    "WLT",
    "VBA",
    "Concentrix/Gias",
    "Illumifin",
    "Google Wallet",
    "Apple Wallet",
    "Zelle",
    "Availity"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "SOC 2",
    "ISO 27001",
    "No Surprises Act",
    "Transparency in Coverage Rule"
  ],
  "certifications": [
    "HITRUST Certification"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US-only",
  "customers": [
    "Scripps",
    "Zelis Payments"
  ],
  "user_reviews": [
    "The team is comprised of agile and tenacious people who are willing to take risks and make sure that their actions are consistent and effective.",
    "I have worked with Lorie P on getting multiple Tax IDs set up to get enrolled in Zelis Payments, and she makes the process so smooth and easy.",
    "Zelis representatives are quick to respond to your concerns. The representative Giovanna Dumbadse was so upbeat and knowledgeable about our choices and how the process worked.",
    "Haley has taken Scripps under her wing and has supported us with EFT registration. She is responsive and educated.",
    "I deeply resent this company for signing me up for services I do NOT want and forcing it on me against my will so that I have to spend two hours on the phone once a year reversing it.",
    "Zelis has a lot of great product offering. We appreciate their innovative ideas and solutions to the industry. Very impressive with the native wallet and super curious about the zchecks to come!"
  ],
  "ratings": [
    "3.9/5 (17 reviews) - G2",
    "4.3/5 (17 reviews) - G2",
    "2.7/5 (11 reviews) - G2",
    "4.3/5 (13 reviews) - G2",
    "4.0/5 (17 reviews) - G2"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2016",
  "integration_partners": [
    "TriZetto Facets",
    "CareCloud Central",
    "InstaMed",
    "NaviNet Open"
  ],
  "id": "SW2700",
  "slug": "claims-insights",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/claims-insights.json"
  }
}