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Complaint Details
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Initial Complaint
07/22/2024
- Complaint Type:
- Billing Issues
- Status:
- Resolved
Zelis added a payor through them without contacting me regarding whether I wanted to be paid through Zelis. They did this with two payors. This has cost me money because they charge me where the payor was paying me directly at no cost to myself. I contacted Zelis regarding this over a month ago. I received one call but I have tried numerous times to reach that person and they have not returned my call. They have not removed those payors from my account so it continues to cost me money. I also informed them that I want to cancel my contract with them. The contract states that I can do that with a 30 day notice but does not provide me with where or to whom I am to give that notice.
Business response
07/26/2024
Dear *****************************,
A member of the Zelis Payments team has been in contact with your practice and assisted with updating the status of your account. Please let us know if we can help with anything else.
Thank you
Zelis PaymentsCustomer response
07/27/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me at this time. I do reserve the right to open another complaint if this does not fully resolve and I do not start receiving the payments as I have requested.
Sincerely,
*****************************Initial Complaint
06/30/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
I am waiting for a $1000 reimbursement from *****. My son's dentist has contacted Cigna numberous times (roughly 10) to follow up, and each time, ***** says that Zelis has yet to forward the money to Cigna, so Cigna can't reimburse us.Business response
07/09/2024
Dear *************************,
Zelis has been in contact with your dental provider and is currently in the process of working to reverse the funds back to the payer. In the upcoming days the funds will be received by the payer and will then need to be reissued. Please let Zelis know if there is anything else we can assist with.
Thank you
Zelis PaymentsCustomer response
07/11/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*************************Initial Complaint
06/13/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
04/24/2024 $118,046.48 was withheld from us due to ***************** supposedly not giving authorization to pay. When I called ***************** to verify this information I was informed that they released the money to Zelis on the 4-24-24 and that they showed the money being cashed by virtual card on 5-20-24. I explained to Banner what Zelis was telling me and they said they were going to open an investigation. I called back Zelis and was then told that ***************** never Released the Funds to Zelis and would open a case of their own and contact Banner for Authorization to release funds #PPO-209791 with ***** telling me that "they can take as long as they want".Business response
06/20/2024
Dear *********************************,
A member of the Zelis Payments team has been in touch with your practice and aided with your inquiry. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsCustomer response
06/20/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*********************************Initial Complaint
05/29/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I am a behavioral healthcare provider contracted with several insurance companies to provide therapy services. In order to be paid for work I already performed, Zelis has told me I owe them a fee of 1.9% of ********. They claim that the 1.9% fee is for the convenience of using their online portal, their direct deposit, and the clearinghouse where information is exchanged with my software. My other option is to receive paper checks. I'd be happy to get paper checks and not pay the fee. However, I think this business practice is unfair because the paper checks do NOT come with explanations of the benefits of the insurance members. Meaning, if *** sees me and owes his full fee because he has a deductible, Zelis will not release that information unless I pay. There is no other real option but to pay them if I want to be paid. I am complaining because they need to at least send out an explanation of benefits and payment owed just like EVERY other insurance company does. This is strong arming us providers and pushing more of us to private/cash pay only and a disservice to those who need therapy services with their insurance. I've only paid them $44 so far, but this is just the start.Business response
06/07/2024
Dear ***********************,
A member of the Zelis Payments team has attempted to connect with you via phone but have been unsuccessful. Please feel free to return our call so that we can address your concerns.
Thank you
Zelis PaymentsCustomer response
06/07/2024
Complaint: 21774172
I am rejecting this response because:
I did email the representative from Zelis today around noon at the email he specified to outline my issue.
Sincerely,
***********************Business response
06/14/2024
Dear ***********************,
A member of the Zelis Payments team has been in contact with your practice and helped with your outstanding concerns. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsCustomer response
06/14/2024
Complaint: 21774172
I am rejecting this response because:
I have been emailing with 2 representatives from Zelis, we emailed as recently as today and have not reached a resolution. The emails I have been sending and receiving are with****************************************************************
********************************************************Sincerely,
***********************Initial Complaint
05/20/2024
- Complaint Type:
- Order Issues
- Status:
- Resolved
Zelis handles healthcare payments for various insurance carriers. We recently had two clients present with *********************** as their TPA, which utilized Zelis as their payment provider. We signed up for EFT and ERA's for all payers (which would include ***********************) in March of 2021 with Zelis as they handle payments for two carriers, *************** that we've had longstanding relationships with. Both members were seen in March to the present time and claims remain unpaid by Zelis to date. Zelis from two weeks after initial claims continued to lie to me in phone and email correspondence blaming *********************** for delay in payment. However, upon checking with ***********************, Zelis finally admitted that they are the issue. However, they are in no hurry to issue payments. We are now two months since the first claim and no payment. They continue to claim they are allowed more time, which makes no sense since again, we signed up for ALL PAYERS in March 2021. Zelis remains a problematic company in the healthcare world due to their slow processing timelines and further is the ONLY company we are forced to participate with that charges fees for EFT payments. So not only are we forced to use this company due to payer arrangements, they buck industry standards by charging fees where other companies don't, and in the process have the SLOWEST processing timelines of any payer we work with. These outstanding claims needs to be paid immediately upon receipt of this complaint. *********************** indicated that the first claim, March 20, was paid on 4/17 to Zelis, so again, a month later, Zelis continues to hold payment hostage until they feel like getting to them. For reference, other insurance carriers we work with that do not utilize Zelis, thankfully, payments are made within 5 to 14 days following the date of service, via EFT, and without any fees. I'd understand their fees and find them more tolerable if they processed claims in a timely manner.Business response
05/28/2024
Dear ******************************,
Zelis Payments has been in contact with the health plan and received confirmation that once funding is received the payments will be released. Over the past week several of the payments that were on hold have been released by the health plan. Please let us know if we can assist with anything else.
Thank you
Zelis PaymentsCustomer response
05/28/2024
Complaint: 21729966
I am rejecting this response because:Once again, I've reached out to *********************** and they deny any and all accusations on the part of your company that any funds are now nor have ever been withheld by the ***. They continue to refer me back to you and state that you should have paid the claims by now, 3/20, 3/26, 4/9, 4/24. 5/14 and 5/21 are still too recent, I'm sure. You randomly paid 4/16, but sent duplicate denials for 3/20 and 3/26, instead of the actual paid claims, with 3/20 being the *** transaction referenced in the screenshot attached. I will be contacting the insurance commissioner in our state tomorrow and in your state next as between you and the *** someone is clearly lying.
Sincerely,
******************************Business response
06/05/2024
Dear ******************************,
A member of the Zelis Payments team has been in contact with your practice and addressed any outstanding funding questions. Zelis has also been in touch with multiple health plans and shared feedback regarding the funding delays you have experienced. Please let us know if we can assist with anything else.
Thank you
Zelis PaymentCustomer response
06/05/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
******************************Initial Complaint
05/14/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
My web account has been locked and it has taken them 3 weeks and they are still unabale to unlock my online account. I want my web account unlocked so that I can access insurance payments that I am supposed to recieve.Business response
05/15/2024
Dear *****************,
A member of the Zelis Payments team has been in contact with your practice and aided with access to your online account. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsInitial Complaint
05/01/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
We are a small medical practice forced to accept payments from Zelis on behalf of certain insurances without our permission or prior notification. We are asked to pay 1.5 - 4% additional fees just for using their service, which, in our opinion, does not offer any real advantage over old paper checks or direct EFTs. They fail to disclose the fees they charge. This predatory payment practice needs to be stopped. Please stop robbery from physicians' offices that are already struggling to stay afloat!We have checks that were supposed to be issued by mail or faxed as their virtual cards often fail to work, we didn't receive checks or faxes. One time, their representative refused to divulge the amount on the card that was going to be faxed, Don't believe their lies. When you call again, their representatives push back and rude. They prey on small medical practices.Business response
05/07/2024
Dear *************************,
A member of the Zelis team has been in contact with your practice regarding your online inquiry. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsInitial Complaint
04/25/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Since the beginning of the year we have been trying to create a Zelis Payments account. I have filled out the website enrollment page several times, called, filed multiple tickets. Each time I call Zelis, they advise someone will call us or reach out to us. We have not heard back a single time. gave my cell phone and desk phone, yet no one still calls. We are unable to access our ERAS for the Zelis partners. This is beyond frustrating.Business response
05/01/2024
Dear *******************************,
A member of the Zelis team has been in contact with your practice regarding your online inquiry. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsCustomer response
05/24/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*******************************Initial Complaint
04/03/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
We are a small medical practice forced to accept payments from Zelis on behalf of certain insurances without our permission or prior notification. We are asked to pay 1.5 - 4% additional fees just for using their service, which, in my opinion, does not offer any real advantage over old paper checks or direct EFTs. They fail to disclose the fees they charge. This predatory payment practice needs to be stopped. Please stop robbery from physicians' offices that are already struggling to stay afloat!Business response
04/10/2024
Dear Realm Healthcare Inc,
A member of the Zelis team has been in contact with your practice and aided with all current and future payments. Please let us know if there is anything else we can assist with.
Thank you
Zelis PaymentsCustomer response
04/10/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
Realm Healthcare ****Initial Complaint
02/19/2024
- Complaint Type:
- Customer Service Issues
- Status:
- Resolved
I own a private therapy practice. My practice bills health insurances. Recently Zelis has been involved in payment of claims billed to a variety of health insurances. Zelis has been sending virtual credit cards as payment for claims, even though my practice did not consent to this form of payment. This form of payment adds an addition 3.5% as a fee. When I contacted Zelis to ask why I was receiving this form of payment that I did not consent to, the representative became very aggressive and inappropriately pushy in wanting me to continue to receive this type of payment. Then, when I continued to decline, she noted that I would not be receiving payment until they could process my request for this change, noting to me that I would have to wait 4 weeks for this request to be processed. Keep in mind, I did not ever give consent to this form of payment in the first place. I believe this delay was intentional, as a way to continue to try to get me to accept virtual credit card payment. So my payments will be delayed several weeks, due to me declining a form of payment that I never consented to in the first place. I believe Zelis to be an unethical business, a manipulative business. I am concerned that insurances such as Anthem, Encore, etc are in collaboration with such an unethical business with so many complaints against them.Business response
02/28/2024
Dear *************************,
Zelis Payments has made multiple attempts to contact you on February 22 and 27 to address your concerns regarding your recent interaction with Zelis. Please feel free to contact us back and we would be happy to assist.
Thank you
Zelis PaymentsCustomer response
02/29/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*************************
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Contact Information
Customer Complaints Summary
82 total complaints in the last 3 years.
26 complaints closed in the last 12 months.