Zelis Customer Service — Professional Guide for Providers, Payers, and Partners

Overview: who Zelis serves and what to expect

Zelis is a healthcare payments and network solutions company that operates at the intersection of payers, providers, and technology. Their services include claims payment, provider network management, payment integrity (claims editing and audit), and payment delivery (EFT, virtual card, paper check) through both portal and API offerings. For providers and payers working with Zelis, customer service is focused on reconciling payments, correcting remittance advice (835/ERA), resolving claim denials tied to edits, and onboarding or integrating technology.

From a customer-service standpoint, Zelis engagements typically involve three distinct parties: the payer (the Zelis client), the healthcare provider, and Zelis support roles (tiers of technical and payment operations). Expect service interactions to require references (remit advice numbers, claim control numbers, provider NPI/TIN, and date-of-service) and to involve both portal-based case tracking and phone escalation when financial corrections are required.

Primary contact channels and where to start

The authoritative entry point is Zelis’ corporate site and contact page: https://www.zelis.com. Use the “Contact Us” or “Support” links to locate the correct channel for provider payments, network inquiries, or client implementation. For most day-to-day issues providers should first access the Zelis provider portal (self-service tools are available there for payment detail, EFT enrollment, and remittance retrieval).

If you don’t have portal access, the fastest route is to open an electronic support request through the payer who partners with Zelis. That request should reference the payer’s assigned case ID and include Zelis remittance IDs from the EOB/EFT. When phone contact is available, have these identifiers on-hand so the agent can pull the exact transaction instead of starting with general account lookups.

What to have ready before you call or open a case

Providing complete documentation on first contact reduces average handle time and speeds resolution. Typical required data points include: provider NPI and tax ID (TIN), patient member ID, date(s) of service, claim control number (also called an internal reference number), the remittance advice (835) extract or screenshot, and the exact dollar amounts in dispute. If the issue is payment-related, include bank routing and account hashes only when requested through secure channels.

• Essential items: provider NPI, TIN, claim control number, date of service, remittance ID (835), explanation of benefits (EOB) PDF or image, any prior authorization numbers.
• Helpful attachments: screen capture of portal payment detail, EDI interchange trace number (if known), ERA/835 byte offsets or segment identifiers for precision, and name of payer-managed client.

Having these ready allows Tier 1 support to escalate to operations (payments) or technical teams (EDI/API) without re-collecting basic facts, and typically cuts resolution time from weeks to days for straightforward discrepancies.

Common issues, root causes, and practical troubleshooting

Typical problems that trigger Zelis support calls include: (1) missing or delayed EFT/virtual card payments, (2) remittance advice mismatches between payer and provider ledgers, (3) claims adjusted by payment integrity edits, and (4) enrollment or credentialing problems that block automated payment delivery. Root causes are often data mismatches (bank account details or NPI/TIN inconsistencies), EDI transmission errors, or upstream payer policy adjustments (e.g., a network contract change or audit).

• Fast troubleshooting checklist: verify portal payment history and transaction ID, confirm bank details and EFT enrollment effective date, compare claim-level adjustments on the 835 to the explanation codes, and request transaction trace from Zelis ops with timestamps for ACH or virtual card issuance.

For denied or modified claims, request the payment integrity rationale and any edit logic (CPT/ICD mapping) used. For payments, ask for the transaction trace and settlement date; ACH settlements typically appear on beneficiary accounts on the settlement date listed in the remittance, but ACH timing can vary 1–3 business days depending on bank processing.

Service levels, escalation, and what to expect in timelines

Service timelines vary by issue complexity and contractual terms between the payer and Zelis. Simple inquiries (status of a posted payment, retrieval of an ERA) are commonly resolved within 24–72 business hours via the portal. Reprocessing or issuing corrective payments can take 5–15 business days once the root cause is established, because these require auditing, approvals, and sometimes payer sign-off for additional disbursements.

If a Tier 1 agent cannot resolve an issue, ask for escalation to a named operations analyst or Implementation/Technical Account Manager and record the escalation ticket number. For mission-critical financial disputes (e.g., a large-dollar mispayment affecting cash flow), request an expedited review and an estimated resolution date in writing — most enterprise contracts provide for escalation SLAs in 48–72 hours for critical incidents.

Technology integrations, EDI, and API support

Zelis supports standard EDI transactions (837/835/270/271) and increasingly provides RESTful APIs for payment status and remittance retrieval. When integrating, insist on test environments (CERT) and detailed implementation guides that list payload examples, authentication methods (typically OAuth2 or mutual TLS for APIs), and expected response codes. Use end-to-end testing with simultaneous payer and Zelis participation to avoid “works in test but fails in production” issues.

Keep these integration best practices: version control of your EDI maps, log all inbound/outbound payloads for the first 90 days after go-live, and establish a scheduled reconciliation job that compares received ERAs to paid transactions daily. This reduces exceptions and creates a clear audit trail for customer service escalations.

Final practical tips

Document every interaction: date/time, agent name/ID, ticket number, and promised follow-up. Use clear subject lines like “URGENT: Missing EFT – Claim Ctrl# 123456 – DOS 2025-04-12” to prioritize handling. Maintain a central folder with remittance documents and copies of any secure messages or portal confirmations — this saves hours during escalations.

For authoritative resources and to open cases, start at the company site: https://www.zelis.com. If you are a provider embedded in a payer ecosystem, coordinate with your payer’s provider relations team first; they can often route and prioritize cases with Zelis under contractual channels quicker than individual provider calls.

How do I contact per pay?

How You Can Contact Us. You may email us at [email protected] to request access to, correct, or delete any personal information that you have provided to us.

What kind of insurance is Zelis?

Zelis works for 770 health insurance companies, ranging from national carriers and dental plans, to BCBS and regional plans, to third-party administrators. We help you balance access with financial performance.

What are the hours for Zellis?

If you need to update your Clearinghouse election, you may do so by updating your provider settings on our portal at provider.zelispayments.com or by calling us at (877) 828-8770 between the hours of 8:00AM – 7:00PM EST Monday – Friday.

How do I change my payment method on Zelis?

Providers can contact Zelis Provider Services via 877-828-8770 or [email protected] if they have questions or want to change their payment method. Payment modality will continue to show “check” in Amisys. Contact Center staff can access the Payspan portal to view payment modalities as they do today.

How do I contact Zelis Payments provider?

If you have questions regarding the registration or electronic and print payment fulfillment processes, please contact Zelis Payments directly at (877) 828–8770.

What did Zelis used to be called?

Zelis has a legacy in claims cost management, having been founded back in 1995 as Stratose® where we initially focused on wrap network services and later added out-of-network services, claims editing, bill review, and audit services in the early 2000s when we acquired phx.