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Zelis® Healthcare Begins Deployment of Machine Learning-Enabled Payment Integrity Platform
[July 17, 2018]

Zelis® Healthcare Begins Deployment of Machine Learning-Enabled Payment Integrity Platform


Zelis Healthcare, a market-leading healthcare technology company today announced the launch of its proprietary, fully-integrated Zelis Intelligent Claims Routing Platform enabled by Microsoft (News - Alert) Azure. The new platform leverages Microsoft Azure Artificial Intelligence to deliver one of the healthcare industry's first machine learning-enabled claims editing platforms.

The Zelis Intelligent Claims Routing Platform is fully-integrated, real-time with a comprehensive range of adjudication platforms, and deploys Microsoft Azure Machine Learning and Azure Data Lake capabilities that help unify claim workflows to deliver market-leading coordination, transparency, efficiency and pre-payment claims cost savings.

"We are pleased to be one of the first healthcare technology companies to bring machine-learning solutions into production. Our Zelis Intelligent Claims Routing Platform delivers a three-dimensional view of healthcare claims enabling the application of a comprehensive range of proprietary savings channels on a customized basis for every claim," said Doug Klinger, CEO of Zelis.

"The Zelis Intelligent Claims Routing Platform leverages Azure Machine Lerning to continuously teach systems about patterns and regularities in claims and payment data; learn and generate insights to help propose the best approach; create new sets of rules to identify increased saving opportunities and deliver customized, personalized and actionable insights that can positively impact future claims," said Tim Wilde, Chief Technology Officer of Zelis.



"Zelis is delivering solutions to help transform the healthcare landscape by untangling the complicated claims and payment process," said John 'JG' Chirapurath, General Manager, Azure Data & Artificial Intelligence. "Azure Machine Learning allows Zelis to quickly generate insights to healthcare claims and will keep looking for ways to reduce costs over time."

The U.S. healthcare industry faces rising cost and increasing complexity due to errors, waste, fraud and abuse. Zelis is experiencing initial gains from the application of machine learning to the pre-payment claims cost management process with claims cost savings improvements in excess of 1000%. While the healthcare cost management industry is in the earliest stages of applying leading edge technology to age-old challenges, the early returns are promising.


About Zelis Healthcare
Zelis Healthcare is a healthcare technology company and market-leading provider of integrated healthcare cost management and payments solutions including network analytics and design, network access and cost management, claims cost management and electronic payments to payers, healthcare providers and consumers in the medical, dental and workers' compensation markets nationwide. Zelis Healthcare is backed by Parthenon Capital Partners. www.Zelis.com


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