I wanted to inform you about an important action we are taking to address recent duplicate payment errors. On Tuesday, September 16th, we will be sending out faxes to 270 providers, requesting them to contact us regarding these errors.

Due to technical constraints, we are unable to include the specific payment IDs in the fax broadcast. To manage this, we have placed a pinned interaction on the impacted provider IDs containing all the necessary details. This will enable us to provide the relevant information to providers when they call in.

Example: https://admin.ppsonline.com/Provider/Edit/660542

Requested actions if a provider calls in:

• If the provider mentions the fax notification, thank them for calling in.

• If you receive a call from one of the impacted providers and they do not mention the fax notification, please inform them of the payment error per the pinned interaction.

• Kindly request that the provider does a purchase return for each duplicate payment.

  • Using the payment details in the pinned interaction, use the card info button to look up the payment amount and date of authorization (the date the card was keyed) the provider may also ask for the date the payment reconciled (settled).

Additionally, the provider may require the last 4 digits of the card, as well as the same information for the other payment to verify they were paid twice

FAQ’s

• Why did this happen?

  • Our payment issuance process performed a duplicate action on June 30th and created two separate credit card payments for the same claim payments.

• Is the issue fixed permanently?

  • Zelis deployed a change to prevent future a reoccurrence of this scenario.

• Which Payment ID needs to be refunded by the provider?

  • Either card may be refunded.

Thank you for your attention to this matter and for your cooperation in resolving these issues efficiently.

Issue:

Since Solis go live on 8/28 payments have not been routing correctly due to a property bag configuration. The property bag has been corrected, and payments are now flowing correctly.

Impact Analysis:

• 38 payments incurred ACH+ fees across 23 providers totaling $12,528.65, 1 provider fee for CAP payment was $11,645.12

  • I am going to look into having the CAP fee refunded

• 578 checks to 372 providers that should have been EPC ACH, 206 checks being converted to ACH before mailing - reduces impacted providers to 327

• 22 VCCs to 13 providers, 16 payments able to be converted to EPC - reduces impacted providers to 6

More details to come as I receive them.  If any provider requests a refund in ACH+ fees please let me know.

Member Transfer

Please be sure to read this message in full and mark as read and understood once you have. The member line is receiving multiple transfers into it where we can't assist.

• Providers should never be transferred to the member line if they do not have the member on the line with them.

• The member line can not assist with payments that have been processed under the providers account, so payments made directly to the provider. They can only assist if the payment was made to the member and these will never be under the providers account, but in the separate member system.

• Before transferring to the member line, please ask your caller "Was this payment made directly to you or to your doctors office?" If the answer is anything other than directly to themselves, please do not transfer. If it was made to the provider, do not transfer to the member line and let the member know to contact the provider directly.

The ePayment Center; free EFT option: We wanted to send out a reminder about our process regarding free EFT requests and the provider's options. If a provider asks about a free EFT option, it is required for us to mention that is something we do offer through the ePayment Center. Please make sure to specify that it is per payer when enrolling with the ePayment Center and submit a provisioning request via Jira if they are interested. Make sure to review the attached document for talking points and let your supervisor know if you have any questions about this. (https://jira.zelis.com/servicedesk/customer/portal/26/create/417) (ATTACHED)

Call Handling Concerns: Leadership addressed a serious and ongoing concern regarding professional conduct during client calls. It is absolutely unacceptable to use profanity on calls, even if you believe you're on mute. It's also unacceptable to hang up on our callers. These actions are unprofessional and reflect poorly on both you and the company. In addition, making any comments and frustration about a caller's accent, communication style, or background is strictly prohibited. This behavior is disrespectful, discriminatory, and will not be tolerated under any circumstances.

Our clients do subpoena call recordings and they do that semi frequently. If unprofessional behavior is captured, even when you believe that you're not being heard, it's not only damaging our reputation, but also violating the trust that we aim to build with our clients. These recordings reflect who we are as a company, and it is extremely disappointing when they reveal conduct that falls short of our standards.

We expect all team members to conduct themselves with the highest level of professionalism and respect on every call without exception. If you are feeling frustrated or need support handling difficult calls, please speak to your manager for guidance.

Legal Action - Reminder: If a caller makes any mention of taking legal action against Zelis in your call, please be sure to pass the details along to a Supervisor so they can handle it further as needed. This does include even minor commentary of legal threats. You may communicate this via email or messaging with the details of your call, so we may pull the call recording and ensure proper actions are taken. 

Dear Zelis Team,

I’d like to make you aware of an article recently published on September 2, 2025, by Claim Depot, an online legal forum, entitled “Zelis Data Breach Investigation.”

There are a number of false statements contained within the posting. Zelis was not impacted by a cybersecurity incident, and there was no incident caused by hacking. All Zelis systems remain secure, fully operational, and safe to use.

We are working with Claim Depot to have the post corrected. There is no action needed at this time. Please do not proactively discuss this with clients. A holding statement has been prepared to help client-facing teams respond to questions.

If you receive any inquiries from clients or partners, please contact Eric Gross, Stephanie Barber, or me. If a reporter contacts you, please follow the guidance below or contact Jon Gregalis.

Regards,

Charan
Charan Singh
SVP, Chief Information Security Officer

Media Guidance – Associates should not engage with a reporter about this news. If you or someone on your team is approached directly, please follow the guidance below:

• If the request is by email, text, or social media direct message (DM): Do not respond directly. Forward or take a screenshot of the inquiry and send it to press@zelis.com.   

• If the request is live via telephone or at an event: Do not engage in a conversation or make up an answer. Instead, you should say, “Thank you for your interest in Zelis. I am not the best person to answer that question. Please contact the Zelis PR team at press@zelis.com.”

🔥For third-party billers, IF there are calls in queue, we should only handle up to 3 payment requests. For the actual providers, we should handle a minimum of 3 payments, if there are more, advise the portal or the automated system will give more payment info through the IVR with TIN and Payment ID. This needs to be done in a professional and polite way.

For example:  "For additional payment details, you’re welcome to use the automated system or the provider portal. Once you're connected you can access payment information by entering your TIN and Payment ID when prompted through the IVR.

This is often the quickest way to get the most up-to-date payment status. If you need help navigating the portal or if anything seems unclear, we’re always here to assist further—just let us know.”

Self-help options win the day!!

Let's talk about Legal issues. When a caller is escalated we want to make sure we are listening for key BUZZ words. Any of the following words used on a call need to be escalated to any available member of leadership IMMEDIATELY! 

These buzzwords include..

• SUE 

• LEGAL ACTION 

• HIPAA VIOLATION 

• NON-COMPLIANCE 

• LAWYER 

• BETTER BUSINESS BUREAU 

• BOARD OF HEALTH 

• IF THEY CLAIM TO "KNOW" OR ARE GOING TO "SPEAK" TO SOMEONE FROM ZELIS 

All of the words above are a sign that this has escalated outside your scope of responsibilities, escalate to a supervisor to make sure that the call does not get any more sticky. If you guys have any questions please feel free to let me know.

MVP Go Live: We wanted to make you aware, payments for MVP go live on 8/18. Provisioning for this payer has already started, as we know. For providers who are opted into VCC's through Zelis, but did not end up enrolling in ePC for MVP, exclusions are being placed on their Zelis accounts for this payer and payments will go as checks. All the provider needs to do to stop receiving checks is for the payer exclusion to be removed from their Zelis profile, or for them to enroll in ePC for MVP.

New Payer: CollectiveHealth:
Go-Live Date: September 17, 2025
ePC URL: collectivehealth.epayment.center

 Provider Communication Highlights:

• Providers will receive a welcome letter based on their current payment method (ACH+ or VCC).

• No action is required providers are already enrolled in the Zelis Payments Network.

• Payments will begin 9/17/25 under the same terms they have today.

ACH+ Providers Will See:

• Confirmation that payments will be delivered via ACH+.

• Messaging emphasizes security and efficiency.

• Reinforcement that no further steps are needed.

VCC Providers Will See:

• Confirmation that payments will be delivered via Virtual Credit Card.

• Messaging highlights the continuation of service with no disruption.

• Reassurance of secure, efficient payment processing.

Note:
Attachments of both letter versions will be shared for reference.

HCSC: Payment Processing Error / ACH+ Fee Refund Update: Zelis will be issuing refunds in the coming weeks for providers who were incorrectly charged ACH+ fees under HCSC’s “free” payment solution.

Key Points:

• Providers who were charged over $100 in fees will receive automatic refunds from Zelis.

• Providers who were charged under $100 will not be refunded automatically.

  • However, if a provider contacts Zelis or HCSC and requests a refund, we will process it.

  • A small group of providers in this category has already called in and will be refunded.

What You Need to Do:

• If a provider reaches out regarding ACH+ fees, provide the necessary contact information to a Team Lead and it will be forwarded on further for processing.

• Interaction notes will be added to accounts that are receiving automatic refunds.

We’ll share the provider communication from HCSC once it becomes available.

R-Codes Update: We wanted to send over some information that we recently learned for R-Codes, as well as directions for the time being. Please make sure to review the below in depth to ensure we are providing the proper guidance. 

As of Monday morning, PINs removed the "R Code Addressed" option in the verification escalation Jira form and replaced it with "Suspension - Workflow 7" because that is the only type of R Code PINs can assist with. Workflow 6 & 7 should show under the bank accounts tab. Those two workflows require PINs to make outreach to the provider. All other R-Codes are handled by either CARE, PE, or the Recoupments & Collections team. We are currently working together to align with a process for our team to send R-Code follow-up/inquiries to the appropriate teams. 

For now, CARE and PE are requesting work items to be created for the associate that enrolled the provider. The work item type should be Sales > Conversion Lead - and add "Pre-Note Failure: R-Code XYZ" in the notes section with it assigned to the appropriate associate.  

If we cannot locate a recent enrollment that was completed by a CARE representative or a PE representative, please have the agent send over the information to the supervisors (TIN, PVID, Contact Name, #, Email) and then we will send over the information for review to Recoupments & Collections. As always, look out for flagged interactions for actions that have already been completed. 

For easy reference, here is the link to the R-Codes and their corresponding processes:  ACH Return Codes.pdf

As of this morning, it was brought to our attention that some HCSC (Blue Cross Blue Shield) payments may be missing a digit for the providers on the end of the PID number. So for example a PID may show as “1000890787” for the provider but it is actually “10008907878” in the account.

Can we make sure all agents are aware of this?

If we can remind them that HCSC (Blue Cross Blue Shield) payments start with “1000” and not all payments will have a 6 or a 7 to start, I would appreciate it. Some also may need a reminder that Blue Cross Blue Shield may be what the provider calls HCSC payments.

The Payment Ops team is working to resolve some payment issues at this time so apologies may be needed if issues arise to that end for callers. It looks like VCCs are being converted to check when errors are found.

  It was recently uncovered that HCSC sent payments to Zelis in error and as a result providers that should have received “free” ACH through HCSC received ACH+ and VCC payments through Zelis.

We are currently working to compile a list of impacted providers and will be working to refund any fees that were charged in error.  At this point in time, it is unknown if HCSC or Zelis will perform the refund.  Please have the associates apologize for the error and communicate that any fee charged in error will be refunded.

Stay tuned as more information becomes available.  Thank you

Ayin Health Communications: Communication is going out to a select group of TINs regarding their change in payment method following their migration from Payspan to Zelis. The communication informs them that their electronic payments previously issued through Payspan will no longer be available, and instead, all future stipend disbursements will be issued as paper checks until further notice. See below for the communication:

EPC - Check Payments VS. ACH Payments Issue: We have identified an issue with payments coming over as expedited that is causing them to come as check even if the EPC is enrolled. Cigna Supplemental is a big impact percentage in this issue. For the time being, we don't have a fix so our only course of action is to have payments reissued as ACH. This is being discussed amongst IT to find resolution. For now, please submit the Payment Escalation Jira ticket to have the payments reissued as ACH payments. (https://jira.zelis.com/servicedesk/customer/portal/26/create/515) 

HCSC & ZAPP Updates: Providers for BCBSNM, BCBSOK and BCBSMT have been receiving payments with the payee indicated as Health Care Service Corporation (HCSC) since 7/14 from JP Morgan Chase. The payee is expected to be reverted to BCBSXX by mid next week. See the example below which shows the payer as HCSC as well as the group code/name as BCNM – BlueCross BlueShield of New Mexico.

Admin Permissions - Multiple Admins: 

After reviewing questions being asked to the TLs, if there are multiple admins, what are the differences? 

Good news! There isn't any differences other than creation date. The original admin was created first which can be seen in their permissions, and they have the ability to create users that have the same exact permissions that they have without any major differences. If an admin grants another user all permissions, there will then be two admins available for the office. 

Example PVID: 231290

Carelon Partnership:

Our partnership with Carelon is expanding! On 8/1 we will be partnering with Carelon Health, payer ID 4170. Now that we support multiple Carelon partnerships, please be careful when provisioning requests are submitted as we will need to be sure to choose the correct one. Letters will be going out to providers shortly, so we may start seeing calls come through very soon. Carelon Health will have an ePayment Center.

Market Campaign Code – NEWPAYER:

We have started tracking calls that were generated because of new payer/migration announcements being sent out. Going forward, calls should be tagged using the “This is a Marketing Campaign” identifier with the Campaign Code as “NEWPAYER”

Invalid Notification of Change (NOC):

It was recently uncovered that Zelis received several Notification of Change (NOC) requests from UMB that contained bad data.  As a result of the NOC, the system automatically updated ~60 providers bank accounts and moved them into an unverified status.  When this happened, checks started to go out to these providers since the new bank accounts were waiting to be reviewed by PINS.  The team is now in the process of reviewing all impacted providers and updating their bank account accordingly and opting them back in to ACH+. 

Information Only:

A Notification of Change (NOC) is a formal message sent by a receiving bank to inform the originator (payer) that the bank account information used in an ACH (Automated Clearing House) transaction is incorrect and needs to be updated. These are governed by NACHA rules, which apply to all ACH transactions in the U.S.

The purpose of NOCs is to ensure future ACH payments are processed correctly by updating outdated or incorrect account details.

🚨Below is some information regarding a recent error that occurred where some Allied payments were duplicated. Lets make sure we read the notes on these and following the instructions below.. Here is a sample of what the flagged interaction note will look like for VCC payments that were duplicated.  The agent will need to advise the provider to perform a purchase return on one of the cards.  🚨

 Zelis would like to start tracking inbound calls that were generated because of new payer/migration announcements being sent out.  (mail, email, fax)  Please begin tagging interactions with the marketing campaign code “NEWPAYER” when a caller states that they are calling because of communication that they have received.  

Payments On-Hold Verbiage: We wanted to share a reminder for payments reflecting the "On-Hold" status, please do not inform the caller it is "on hold". Instead, please advise the caller that the payment shows that it is "awaiting group approval" moving forward. Per the feedback from the Payment Operations team, providers are reaching out referring to payments "on-hold" which is causing further escalation and issue with resolution. Please remember to review and advise the approved provider verbiage within the Jira ticket for Payments On Hold.

Quest Diagnostics -835 Routing Error: 835 Files for Quest Diagnostics on 6/11, 6/24, and 6/25 were sent to the clearinghouse Availity instead of PNC.  The EDI team is currently working to have the files regenerated and forwarded to the correct clearinghouse.  As part of an upcoming release in the admin portal, a fix will be put in place to prevent this error from happening again.

Impact:

• 178 files

• 19 provider TINS

• 16,510 payments

ePayment Center - Ameritas: We have been informed of provider's calling in referencing the payer, Ameritas, and requesting steps on how to enroll for the ePayment Center. Providers are able to move forward with the enrollment process utilizing the payer URL of - ameritas.epayment.center. The provisioning form is updated as well to allow our team to submit the request as needed. An important thing to note is we have not yet went live with payment processing for Ameritas, so enrolling at this time is just for providers to be proactive for when we do go-live. We have been advised that Ameritas go-live is set for the end of this week, however, we can advise that once payments begin, they will flow through their EPC set-up appropriately if their enrollment is completed. 

Team, for informational awareness If a provider reports that a check was stolen and subsequently cashed or deposited, here’s the recommended process. First initiate a Check Copy  Request (JIRA): Offer to submit a check copy request so the provider can verify exactly where the funds were deposited or cashed. Then the Provider will review the Transaction Details Once the check image is available, they can confirm whether it was deposited by the intended recipient. Finally if Misrouted: Should the check have been deposited into the wrong account, the agent should promptly submit a Misdirected Funds JIRA to escalate the issue for resolution.

Please do not transfer new TIN enrollments to Provider Enrollment (PE). The payer will initiate the process by sending us the first claim, after which the new TIN will be opened. Note: PE does not handle new TINs. 

NEW JIRA LINK FOR REPORTING A JIRA OUTAGE 🥳
This link has been added to the  JIRA LINK PAGE  in ZOARP! We will use this link when there is an outage on JIRA. This will help the IT team know there is a wide spread issue and they can get it fix quickly!!
The link : https://app.smartsheet.com/b/form/dd049bfe53a34f21b3303c1bafad4545

All VCCs and ACH+ options for the following payers have been turned off. Providers will receive checks only from these payers.

Allstate

Nationwide

NY Mutual

American National

The following verbiage can be used if the question is asked.

If a provider is inquiring about why they did not receive an electronic payment the standard verbiage of “Zelis was unable to pay the payment electronically and as a result a check was used” should be used.

        Metlife update:      

Cards can be reissued if the provider has a “system error” message.

 They will not be able to process the card.

A reissue as credit card option has been added to the PayOps intake center form MetLife VCC Reissue.

If a provider prefers a check, we should convert the payment.

Fax and Download providers will be able to get a reissued card faster than a check.

When the provider asks: PMA is also Pennsylvania Manufacturers Association, might have them listed under the full name and the connection is not being made to abbreviated PMA when a provider calls. 

 We have had some providers calling in regarding their Consolidated ACH payments not being consolidated which caused extra fees to be assessed. This was reported and has now been fixed as of today. If you all get a call like this, say this script!

“Thank you for bringing it to our attention. It is a known issue with consolidated payments that was fixed as of May 1 after we were made aware. We apologize for the inconvenience.”

We have received notification that we have temporarily suspended paying Allstate payments electronically.  (no VCC or ACH+)  If a provider is inquiring about why they did not receive an electronic payment the standard verbiage of “Zelis was unable to pay the payment electronically and as a result a check was used” should be used.

Job Posting: Team Lead – Zelis Program

Position Summary:

 We are seeking a dedicated and experienced leader to take on the Team Lead role for the Zelis program. This pivotal position drives team success and ensures exceptional service delivery. Ideal candidates will demonstrate leadership excellence, possess in-depth program expertise, and thrive in a collaborative and inclusive environment.

Eligibility Requirements:

 • Tenure: Minimum of 1 year with the organization (OTD).

 • Program Experience: Minimum of 1 year actively working within the Zelis program.

 • Performance Excellence: Proven track record of outstanding performance in current or previous roles.

 • Standing: Must be in good standing with the program.

 • Availability: Commit to a minimum of 4 hours of phone time per day, totaling 20 hours per week.

Key Responsibilities:

 • Serve as the primary escalation point for complex issues, ensuring swift and effective resolutions.

 • Mentor agents to promote professional growth and skill enhancement.

 • Monitor team performance, identifying opportunities for operational improvements and efficiency.

 • Collaborate with program leaders to align strategies with organizational goals and client expectations.

 • Deliver consistent communication on procedural changes, best practices, and performance standards.

 • Embody and uphold organizational values, championing inclusivity, professionalism, and excellence.

Qualifications:

 • Exceptional leadership skills with the ability to inspire, guide, and motivate a team.

 • Strong problem-solving capabilities and keen attention to detail.

 • Comprehensive knowledge of Zelis program procedures, workflows, and standards.

 • Excellent verbal and written communication abilities.

 • Commitment to fostering a positive, collaborative, and productive work environment.

Why Apply?

 This role offers a unique opportunity to shape the future of the Zelis program, driving meaningful change and empowering peers to reach new heights. If you are passionate about leadership, have a deep understanding of the Zelis program, and are motivated to make a lasting impact, we encourage you to apply.

How to Apply:

 Please submit your résumé to Joshua.lafleur@onetouchdirect.com by end of day Monday, April 21, 2025.

 In your email, please include "Team Lead" in the subject line. 

 HEY HEY HEY We just got a new update with third party billers. With the addition of KORE, we have been asked to change the verbiage when we have a Third Party Biller request more than 3 payments to help mitigate some of the volume to agents.

From now on, when we have a biller asking for more than 3 payments, we should be advising third party billers to call back and utilize the automated system for all additional payment needs going forward. It will give them the necessary information and allow them to look up as many as they need to with no limits! 

EXAMPLE FOR A SCRIPT: I do apologize I am unable to assist with more payments at this time. For additional payment needs, we recommend using our automated system, which has no limits and provides quick assistance.

Examples on what not to say: I cant help you anymore // you reached your limit// byeee 

New VCC Enrollment Verbiage: The verbiage being used when providers are being enrolled into Virtual Credit Cards is updating. As a reminder, Client Services Representatives do not initiate new enrollments. We are sharing this verbiage for your knowledge only. 

“You have asked to enroll with Zelis to receive claim payments by single-use virtual credit card and acknowledge that interchange and other third-party fees may apply as set forth in the agreement between you and your merchant processor or financial institution.  At any time, you may contact Zelis to change your payment preference to another payment method, including ACH and check.  Is that correct?”  [Wait for the Decision Maker to agree before opting-in]"

Misdirected funds - ACH Addition: The Misdirected Funds JIRA ticket has been updated to now allow submission for ACH payments. If the “VRA Direct” button is selected, another question will appear asking if it is for more than 1 payment. If so, the ticket will expand to allow up to 10 PIDs to be entered in one request. 

Fee Reports: ACH+ accounts that are enrolled into Net no longer need to send an email to csdept to receive a report for their fees! Providers enrolled in Gross fees for ACH+ as always can obtain their fee reports on the portal, but for Net fee reports, we can now submit the following ticket for fee reports. 

https://jira.zelis.com/servicedesk/customer/portal/1/create/1162?q=report&q_time=1743786468867

Admin Update Requests – Updates & Reminders:

• Advising Providers to reach out to adminupdate@zelis.com (Only for ZPN):

• If a caller has received an admin update letter with a “key code” (usually a series of numbers followed by 2 letters), we can ask them if they have responded to the email that was sent from adminupdate@zelis.com. This email is normally sent the same day as the key code is sent in the mail, so it can be common that the provider may have forgotten about it by the time the letter arrives.

• If they did not receive this email or if they deleted it, they can send an email back to adminupdate@zelis.com with the key code, their TIN and contact information. It is very important that they include their TIN and contact information because larger providers with multiple TINs may be in the process of requesting more than one admin update at a time.

• Refresher on key codes:

• The key code is mailed to the provider’s practice address 1-5 business days after an admin update request has been submitted. This is completed for both Zelis and EPC.

• The purpose of the key code is only to be used as part of our security process to ensure that an admin update has genuinely been requested by the provider. The key code cannot be used anywhere on the portal to reset or update a portal admin account or a password.

• The key code is not to be confused with the portal registration code. The registration code is only used when there is no portal account yet.

A little over a year ago, we had gone through some misdirected funds info and there was a link sent over the misdirected funds JIRA link. I know we were having some issues getting those handled correctly.

Here is the link to that JIRA form.

Misdirected Funds - Payment Operations - Service project

Zelis can and will recoup payments. We have a part of the Payment Ops team that does this for us. If there is a “processed – paid” status and the provider claims they have not received the payment. They will investigate the issue and recoup if necessary. If the payer needs to be involved, that team will also involve them to assist, however, in many cases, we are able to handle without including them.

🚨SFAX REMINDER 🚨

When setting up an SFAX it is critical that we use cover page on EVERY outgoing fax from your departments. It’s a critical item since its purpose is to protect PHI that could otherwise be viewed if a cover page was not included. 

I just wanted to send an updated list of what Price Optimization handles since we have received a few questions about it recently.

• At a high level, below are the types of calls that the Price Optimization Team handles:

  • Status of a claim received by Zelis

  • Education on Zelis pricing/discount

  • Inquiry/Dispute status

  • Provider network participation status (par vs non-par)

  • Member assistance with locating a provider in a Zelis network

  • Negotiation calls

  • NSA (No Surprises Act)

  • Dental calls (Relating to emails from dentalppo@zelis.com, not payments)

• Calls that the Price Optimization Team does not handle – the calls below should be redirected to the Payer/Client:

  • EOB requests

  • Patient/Member benefit information

  • Pre-certification

  • Payment information

Zelis IT has created a JIRA for us to use to report providers having issues getting their payment reports or any other issues regarding their payment reporting on the portal. 

https://jira.zelis.com/servicedesk/customer/portal/1/create/1162

RETRACTION FOR OPT OUT: FOLLOW THE SAME PROCESS WE ALWAY DO UNTIL FURTHER NOTICE! 

Client is working on another update coming soon! 

Hey everyone! Internal is kicking our butt with these surveys scores. We've always been the best and lets keep it that way. An easy fix for everyone, I personally have been including this change on my calls so you're not alone, but if you feel like your callers had a good experience with you, use this new outro!

"Thank you for calling into Zelis. If you wouldn't mind, we do have an after call survey on your experience today. If you've opted into it, I'll get you transferred over. Have a wonderful day!"

QA will be listening to these calls its better to ask people that you know are happy then waiting for that ONE unhappy person to leave a score and that's all you have. Just reminding them at the end of the call and asking is an EASY way to get scores rolling through. Let me know if you're needing any help! 

PINS Self-Verification: PINS is starting a self-verification pilot where if they reach out to a provider to verify the bank on file for their ACH+ enrollment and are unable to reach them, they will be sending the provider an email to verify themselves on the portal instead of needing another call! The provider will receive an email stating that action is required for their pending enrollment. The provider will then have 10 days to follow the link included in their email to log onto the portal. Then, the provider will log into the portal and pull up a previously settled VCC payment. Once they enter the card information into the self-verification bot, that will then complete their verification and the account can be moved to opt-in. If the provider misses this 10-day window and would still like to complete self verification, you would submit a Self-Verification Request jira form.

Below is the email they will receive:

Lumeris (Essence Healthcare): We've received feedback from the payer, Lumeris, stating that they're facing challenges with getting service. We're still investigating why this feedback was provided to us, but in the meantime, please keep in mind that we should not attempt to upsell any providers calling in regards to Lumeris. Please proceed by assisting the provider as normal and guide them to ePC if needed/requested.

Commerce: Zelis is partnering with a third-party company, Commerce! Our partnership with Commerce will be very similar to our Athenahealth partnership in the way we enroll providers and process payments as ACH. There will be a flagged interaction explaining what we can/can’t do for their providers as it relates to their payments/portal/enrollment. Just like normal, we should review the interactions on any account that we open that has a flagged interaction to see how we should handle the account before moving forward with the call. We have attached a document discussing the partnerships and additional information that may be helpful regarding how payments and our connection will function.

Adding the pinned notation for Commerce which describes how our relationship will function. This interaction will be pinned at the top of any account that is part of this relationship. Due to our limited assistance on these calls, please be sure to read any and all pinned interactions on any calls you assist with.

Failed Faxes: Due to the continued cadence of failed faxes, we have reached out to IT for the status on the ticket submitted for this, and our ticket has been moved to the correct team to work. We will keep you updated when we know more. IT has stated that some responses they have gotten so far are "human answer's" and "auto-answers." If you are seeing failed faxes on their first attempt, please probe to see if they have an auto-answering system for their fax machine.

Provider ID Creation - Transferring to PE: We wanted to share that in the event you receive a call, and the TIN the caller provides is not populating in the admin portal, we are able to get them transferred to PE for assistance with account creation. We do not need to turn them away and/or direct them to the payer in these cases as PE has the ability to create their provider account manually on their end.

Urgent Issue

• Production support has determined that an entity by the name of Lassie is scraping our portals twice daily, creating thousands of EOP downloads, causing 2 EPC portals to crash almost daily. Payer 5044/5317 uhcdental.epayment.center and 7376 metlifedental.epayment.center.

  • They are accessing once in the mid-afternoon and once in the late evening.

  • Tech teams have determined, it’s the mid-afternoon requests that are the biggest issue as site traffic is already high at that time.

    • These sites are going down almost daily, and ITOPS/Prod Support then must work to bring them back up.

While Zelis reviews the company and this action the user accounts associated with Lassie are being temporarily suspended and the following flagged note is being placed on the accounts for the agents to communicate.

“Online account access is temporarily disabled due to suspicious activity.  Payments and remits will continue to be processed. Zelis security will contact the provider with further instructions”

The user accounts with an email address ending in “@practices.golassie.com” are the ones being suspended.  Impact ~700 users. 

Here YEE hear YEE It is decreed from the client them selves that "We can give it to them or confirm it. Either or." and "A 2 step is not required for confirming or giving the info of the last 4." Now let me be clear this does not mean you can be like "Hey want the last 4 of the bank info! It's blah blah blah blah"

However if they ask for it, or ask you to confirm it we can do so. So long as they are verified with the TIN.

Now in the past couple of days there may have been misinformation about this, it is no ones fault. The client has just changed their mind is all. We have confirmed this has not always been the case, so no one should feel bad about any misinformation given, or received.  In the end it is on us as leaders to find out this information for you, and distribute it to you as accurately as possible. Bottom line leadership is not perfect, but in the end we will always make sure you have the correct information one way, or another.

And remember if you ever receive incorrect information from a leadership member, it is not on you if that somehow finds it's way back to you. We will always take the heat for it. We are support first leadership second so please don't worry if that ever happens okay? We got you.

**Important: 1099's have been mailed**

1099s have been made available through the Portal and mailed out for check and ACH+ providers. Which means we should be getting some calls on that potentially. We should not be handling these at any time, please transfer those to the 1099 line.

**Reminder: Clearinghouse Enrollments**

Except for Cigna Medical, we should never be enabling a Clearinghouse for any provider that is not enrolled in a product.

**Reminder: Transferring to CARE**

CARE is not a place for ANYONE to send calls if they are confused. The CARE team is the Retention team, not a specialized group that handles our mysteries. If you have questions, reach out in your team channel!

(Project Jaguar) New Payer Questions for Sentara: The Sentara go-live is 02/03, email and letter blasts have been sent out. Sentara will offer both ZPN and EPC. They are coming from Payspan. We are hearing the following questions about Sentara and are working towards finding out more information about the below - 

• Insurance Agents/Brokers are calling in attempting to enroll with TINs that have not received a Zelis payment as of yet. (meaning TIN does not populate yet)

• Callers are stating they do not have an NPI to enroll with when they attempt to - we can advise to use a generic number combination for their NPI to move forward, such as 1111111111 or 9999999999 or 1234567890, etc. 

Centene: The Payspan payer, Centene, has gone live with ICL payments as of 01/28/25. As a reminder, if a provider is currently receiving check payments for Centene today and they are enrolled in the Zelis Network, the check payments will be systematically converted to either ACH+ or VCC. If a provider calls in requesting free/essential EFT they should not be routed to the ePayment Center, however, directed to the Payspan support team for assistance with enrolling. If a provider is not enrolled in ZPN they will continue to receive checks. Centene has sent out communication notifying providers of their options.  

The ePC provisioning form will be updated with the following message: (see below)

New Invitational (AIP): We have a new invitational program that has gone live this week. These are providers who have not historically received VCC's from us, but after pulling data from our partnered merchant terminal companies, they do have a merchant terminal in office. On these accounts, there will be a pinned interaction explaining that the provider is part of this program. On their VCC's they will be directed to call Provider Enrollment to opt out if not interested, but if calls do come into CS, you can opt the provider out. 

Bankers Life - Ph# on Payer Website: We have officially received documentation from a provider of the Bankers Life portal, and we were able to relay the concern of the incorrect phone number (the EPC phone number) being posted on their website. Bankers Life is looking into correcting this, as well as, the IVR directing all callers to EPC. 

Hey guys,

Just a quick update from the internal side. See below for more info.

"Undeliverable" Payments: You may have come across payments with a red text indicating "undeliverable". See example below:

Luckily, this is not a concern for us. This is put in place for internal purposes, but does not mean there is any issue with the payment. As long as we see the payment status is "paid" and there's nothing unusual shown, we can proceed as normal just like any other payment. 

**Important: ePayment Center**

Exciting news! We are launching the Kore.AI IVR update for the ePayment Center and it will go-live as of Wednesday 1/22. This will create a better provider experience and agent experience as we will begin the call with the related payer already prepped for proper conversation.

I’ve attached a documents for your reference—CXOne Max users. This includes a screenshots of what you will see when a call comes in. Please use the payer name presented on your screen once the call is answered to enhance the customer experience. For example:

• "Thank you for calling the ePayment Center, my name is Liz. I noticed you are calling regarding Centene Corporation. May I have your Tax ID Number for verification?"

Please remember that the bot is still learning. While it improves with more calls, there may be instances where no payer name is displayed. In such cases, we will continue the call with the regular greeting without announcing a payer name.

With that said, if a caller expresses frustration about being asked for their payer name again after stating in the system (sometimes twice), agents should respond with empathy….something similar to the one below.

·                     "I’m sorry for any inconvenience. We are testing a new automated system, and it sometimes has difficulty recognizing certain names.”

Updates From Internal

EPC Provisioning Requests - Backlog - Due to some recent technical issues with the EPC emails (which have since been resolved), there is now a backlog. The backlog is specifically for Provisioning Requests, so we ask that you all temporarily advise that the completion timeframe may be slightly delayed for the time being. We will update you all once things return as normal. 

CS Zelis India - EPC & APV Increase: Our Zelis India has expanded their call handling abilities! On 12/19 and 12/20 our Zelis India team learned the EPC skill so now will be able to assist with ePayment Center calls for a list of approved payers. Great to note as well, previously Zelis India agents were only able to assist on ACH+ accounts that had an APV or 30k or less. Starting this week, that APV threshold has been upped to 100k. 

ICL EDI Issue: The EDI team has notified us that as of this moment, EDI files for ICL Payers are not currently being sent to providers clearinghouses. If a provider calls in about a file that was not sent to their clearinghouse, please check to see if the payment is an ICL payment. If so, please let the provider know that this team is diligently working to fix this issue and we are hoping for this to be turned back on soon! More to come when we know more.

New Legislation, Who Dis?

From now on, if a provider from ARIZONA, ILLINOIS, or MISSOURI opts-out of a Select product, you will also put them on the Do Not Call list so they will no longer receive invitationals. They can still receive marketing and advertisements through the mail, but NO MORE invitational until they choose to enroll at a later time. 

If we send to CARE/PE we still own the DNC. Fill out the template and send it to your sup's email channel.

Starting in January, no DENTAL providers in FLORIDA will receive VCC invitationals moving forward.

Take some time to study this information and please reach out if you have any questions! 

Upcoming Survey for Calls

A survey is being added as an option to all calls for providers to participate in starting November 1st. This survey will give the ability to rate the service provided and leave verbal commentary if warranted. This survey will be added as of Nov 1st, however, it will not count towards your metrics/performance until Jan 1st, 2025. We are giving the two-month grace period for all to get familiar with the survey option, the appropriate way to launch the survey and learn from any commentary before the survey scores go towards MITs and performance. 

The Zelis IT team is working on improving latency in MP. Starting Monday, October 21, Manage Providers will load and look a bit differently. The plan is to hide some of the data when opening an account to improve performance. Some areas will no longer automatically load. The info is still available, we just have to click now to show it. Hopefully this will improve the speed of loading accounts and looking up information!

We've had an increase in calls from providers having an issue with their direct deposit accounts. Accounts with a small payments value (Low Value Provider) have a faster verification process. Once those smaller accounts reach a higher dollar value in payments, it triggers the system to do an additional bank verification process. This is when we see the LVPThreshold situation occur. The provider will receive checks until the new verification process is complete. This is automatic and we do not need to do anything to start the process or make it go more quickly. 

MetLife Website Walkthrough is now LIVE in the How-To section!

We may NOT give out a username for the portal, even after a 2-step. If a user has forgotten their username, that is a JIRA ticket: Forgot Password / Security Questions Issues. Under Issue Type, there is an option for Forgot Username. The link is also in the JIRA link page in Zoarp.

MetLife is transitioning to pushing payments through Zelis AND through ePayments. Providers will receive one of the attached letters. When they call with questions, you should first have them read the letter to you because there are several different versions. Each letter details what the provider needs to do, if anything. (This is just like the Aetna ASSI thing from several months ago if you remember!) 

Attached are copies of each type of letter along with the dates each group will be sent letters and when the changeover will occur. Reach out with any questions!

New in How-Tos
A list of the things Zelis Healthcare (ZHC) handles and does not handle.

Is it Me or ZHC?

NEW SSO Template, please take note: 

SSO template 

(All information must be filled out)

TIN/Provider ID:

Caller Full Name:

Caller Title:

Caller Phone:

Caller Email: 

Is caller admin or is there an admin update request placed for caller? (If no, request cannot be completed):

2-Step Completed on Primary TIN? (If no, request cannot be completed):

Authorized Decision Maker on Secondary TIN(s)? (If no, request cannot be completed):

Primary TIN:

Primary Provider ID:

Secondary TIN(s):

Secondary Provider ID(s):

Is there an existing SSO for any of the TINs/Provider IDs listed above?

If yes, is the requester aware of this?

If yes, does the requester wish to remove the TIN(s) from the existing SSO and place it/them under the new SSO?

If yes, does this requester have the authority to do so?

***New Suggestion Button At the bottom of ZOARP!!!***

Duplicate Emails To Providers

The ZPS team alerted us that during last night's ZEMA (Zelis Enterprise Mail API) deployment, duplicate emails were sent out to providers.  A total of 5,881 providers were impacted and received two to ten duplicate emails (most received two).  Most of the emails that duplicated were ‘Provider Payment Alerts’ however there was one provider that received a duplicate ‘Reset Password’ email.

If providers call in complaining about the duplication, please apologize for the multiple emails being sent.

The quarterly Provider Outreach campaign has begun.  Emails are being sent to providers contracted with Zelis owned networks.  The request is to review the provider directory information currently on file and respond with confirmation or changes needed.  Should you or any of your teams be contacted by a provider or someone from their office with questions regarding this outreach, please direct them to the email address and/or phone number listed below.   

Email:  Provideroutreach@zelis.com 

Phone: 678-846-2680

CrowdStrike

If a provider were to inquire about the CrowdStrike incident here is the approved language from our legal.  Please ensure that we are not proactively bringing up the situation in conversation.

Zelis is not directly impacted by a CrowdStrike software update that is affecting some organizations' Windows 10 and 11 devices. However, we are monitoring the situation closely.

Please ensure that we have removed (833) 458-2284 from all notes and resources, and are only passing along (833) 458-2283 to our Nationwide callers.

MetLife Pre-Certification and Pre-Estimates: There has been an increase of calls from providers asking for pre-estimates and/or pre-certification, and after further review, we actually may have this information filed as an 835 Delivery. We would search the patient name & DOS of 01/01/1900, or claim# to locate this information. If no results, we then can refer back to the payer.  (example below)

Nationwide Claim #'s: Callers have been providing impartial claim numbers for Nationwide claims. We can begin encouraging providers to give us the Bill ID for us to search in the Claim # field, or to confirm the caller is providing the full claim number shown in the example below and searching in the WC Claim # field: (example below)

Accurate Dispositions: We hear and appreciate when you all bring pain points and/or issues to our attention. You all do a wonderful job at collecting examples such as TINs and PIDs, however, we also heavily rely on accurate dispositions to track the influx in call trends. By selecting the most applicable disposition in every call, as well as, selecting the applicable payer(s), this allows us to have visibility on the impact it has on our call volume.

AI Calls - Possible Aetna Relation: We are further researching the AI calls that have spiked over the past few weeks. At this time, we will not handle/assist the AI calls - "If you are calling in regarding Patient Eligibility, you have reached the Provider Payments Service center and we cannot assist with eligibility questions. If you have payment questions, we do require a provider on the line to assist. Please contact us back with a provider on the line between 8 am and 7pm EST. I will now be disconnecting the call, thank you for calling Zelis."  Please use a positive and up-beat tone as we read this scripting. More information to come as we continue researching the concerns with the payer. 

SmartData Solutions (SDS) - W9 Requests: We are partnered with SDS to retrieve data for our 1099 process. SDS has sent out letters to request an updated W9 or updated business information for our providers. If a provider is calling in requesting the legitimacy of the letter, we can confirm that we are partnered with SDS to collect the requested information.  

Call Recording Requests: We’ve recently received approved verbiage in the event that a caller is requesting to obtain one of our call recordings. As a CSR, we are not authorized to provide call recordings. Please see below for guidance on what to say: “[Insert Client Name], Zelis’ internal policy prohibits the sharing of call recordings. In the event of a criminal investigation and receipt of a subpoena, Zelis will send copies of the call recordings to Law Enforcement.”

The CARE team will be unavailable tomorrow 7/16 from 9:30am – 10:30am. Please have the agents create work items only during that time.

Moving FWD all ePayment accounts must be Opted-Out using the proper JIRA form. Please visit the Opt-Out page for ePayment for an example image and the link for the form. 

https://sites.google.com/view/zoarp/account-types/epay/opt-outs-epay 

Conversion update

Moving FWD all conversions should be transfered to CARE. There are only certain circumstances that you would have to transfer to PE. Please see the updated info here https://sites.google.com/view/zoarp/opt-ins-and-outs#h.60736pd3n2e0 

Third Party Billers

As we all are aware, we have been given a restriction for TPB calls to assist with 3 claims and/or up to 7 minutes of a call. This restriction should be internal knowledge and we should refrain from openly sharing this with callers. Instead, we should flow through our call as normal and once we reach our limit, we can kindly say "Unfortunately, I am unable to look up anymore payments in this call, but we would be happy to assist you with any further payment information. You may call us back at our main line." to prevent caller escalation. Please also keep in mind that we cannot place this restriction on providers, and we are expected to fully assist with all inquiries/concerns. 

2-Step Update IMPORTANT!!

For 2-Step Verifications, we are directly going to the NPPES NPI Registry and reviewing the Last Updated date (example below). If the date listed is within the last 90 days, we complete the Unable to Complete 2-Step form in JIRA (https://jira.zelis.com/servicedesk/customer/portal/47/create/768) instead of attempting the 2-Step Verification call. If the date is greater than 90 days, then we can move forward with the 2-Step Verification process.

Provider Communication: Due to the request being made, we will submit this request to the appropriate team for verification. Please allow this team 5 - 7 business days for outreach.

But something like this can also be used, “It looks like I’m unable to complete the verification myself but I am filling out a form for someone to reach out to you for verification. That is usually completed within 5-7 business days and that will move the process forward for resolution.”

Manny Bizanos is no longer with Zelis. If a work item needs to be assigned and this was the enrolling agent, please just leave unassigned.

Pennsylvania Manufacturers Association Insurance Company (PMA) is a new payer recently onboarded. Providers are starting to call in so please be aware of this.

ePayment portal link (if applicable):  https://pma.epayment.center

Nationwide Insurance

This is how we are directed to handle the calls when the provider is contacting Zelis for payments that were issued prior to their migration to Zelis.

Zelis is only expected to help field questions for payments that Zelis issued. If you didn’t issue the payment and don’t have the claim details on hand, please take the below actions:

1. Ask the provider to call the NW Associate they are working with if they have the contact information.

2. If they don’t have the NW associate number, ask the provider to call the 833-458-2284 number and direct them to speak to an associate and not to use option 2.

From Zelis:

MOO will be moving back to EML as their card issuer.  Below outlines the timing and the impact to the provider.  All cards that were issued prior to the switch will follow the current lifecycle/funding.

• Monday (06/10) we will flip from JPMC to UMB for MOO funding.

• Tuesday (06/11) card creation will begin out of EML – this is the first day providers will receive EML issued cards.

• 48-hour hold will no longer be in play when converting cards.

• No impact to consolidated payments.

• Card expiration timeframe will remain at 45 days.

From Zelis:

Tone/Demeanor with TPBs - Evaluations have been docked recently for tone/demeanor on calls especially with third party billers. Per our quality assurance policy, “representatives must handle calls on an appropriate level, bearing company interests and client satisfaction which includes displaying a can-do attitude and not letting emotions guide your call” and “representatives should not raise their voice." Tone and demeanor concerns are taken very seriously, and we should have an even tone no matter the client type. Third party billers are hired by providers and they should be treated with the same level of customer service as a provider should be.

QA Reminders - We have noticed an increase of points missed relating to providing the incorrect time-frame for faxing EOPs/VCCs. Please remember to state that it can take up to 24 hours for delivery.   You are still able to state they may receive their fax within 1 to 2 hours, however, the 24-hour possibility has to be shared to receive points per QA. 

We also wanted to mention the Ownership and Assurance Statement since this is one of the most commonly missed questions. To receive the 5 points for this area, a statement must be provided after the caller states their request/concern that shows ownership of the call such as these examples, "I am happy to assist with that today." "I can certainly help with that today.", or "I understand your frustration, and I can take a look for you." 

 MFA Refresh - When someone is stating they are locked out of their portal, please ask what messaging they are getting. For security reasons, some accounts are set up with Multi-Factor Authentication. After submitting their username and password, providers will get the below screen (this is similar to how we use Duo on our phones.) If a user calls in and their MFA is locked, please redirect them to the admin on file to reset their MFA in their user profile. If an admin calls in and their MFA is locked, needs updated, or is not functioning properly, provide the phone number for the MFA line for assistance at 833-554-0811. We can also transfer to the MFA line if the provider is requesting to be transferred.

Please be aware:

Network Medical Manager (NMM) recently went through a name change and are now known as Astrana Health.  Right now, the payer team is trying to get the payer’s approval to update their name in our systems. (TBD when this will happen) In the meantime, a provider could call in referencing the payer by either name.

Payment Modality Issue

A recent configuration issue was discovered that resulted in electronic payments for two payers to default to a check.  We may experience an influx in calls questioning why the payment came as a check instead of ACH/VCC. The issue has been resolved and future payments from the two payers will go out based on the provider’s enrollment status.

Impacted Payers:

• Independent Health

• Intermountain Health Nevada

Misdirected Funds vs Payer Issue

1. 1. I got out of a short meeting with the Payment Ops Recoupment team and they asked me to pass along a little bit of info on Misdirected funds regarding VRA payments vs Payer Issues with those VRA payments.

1. 2. If a VRA payment is made to the incorrect TIN, that would not be a JIRA ticket for misdirected funds any longer. That would be something the provider would have to work out with the payer themselves. All we do in that scenario is apply the payment to the TIN listed from the payer. The payer would have to resolve that for them.
      
      This is only VRA payments. All other payment types would use this form. But if it is VRA, then they need to contact the insurance company. 

Change Healthcare Portal Users

• Change Healthcare, Capario and Relay/McKesson portal users that were deactivated because of the security incident are having their passwords and MFA reset.

• If a caller is needing to be reactivated a PINS Forgot Password Jira ticket should be submitted.  (no one outside of PINS is authorized to activate the existing users)

1. 1. Forgot Password / Security Questions Issues - Payment Identification & Network Security Portal - Service project (zelis.com)

   2. Be sure to select “User was deactivated as part of Change Healthcare’s security incident” to give the security team a heads up.

CNO/Bankers Life

Zelis agents should NOT be passing out a phone number for CNO/Bankers Life.  The payer has elected to make their relationship with the provider completely self service and as a result drives them to their portal for assistance.  Please ensure that the Banker’s Life phone number is removed from all resources and is deleted from your personal records.

The new payer Cigna Medical is now live.

Reminder to all to make sure to select the correct payer from the options when dispositioning your calls!

Helpful info - Print Check EP

 If you see EP below a Print Check, it means these are express overnight check delivery. (Expedited Payment) Most of these are from the payer Zurich.

See example payment below.

🛑 NO MORE CONVERSIONS 🛑

Team,

We have been notified that we are not doing CONVERSIONS any longer. This means when someone calls to either enroll into a product -OR- change product type (ex: going from Select Print to Select Download) they will be transferred to Provider Enrollment (over $15k value) or to the CARE team (under $15k value)

Because of the cyber-attack at Ascension Automated Benefit Services (ABS) Zelis is reversing several ACH transactions and issuing a stop payment on some outstanding VCCs and checks for ABS.  As a result, providers may call in questioning a processing error or the ACH reversal.  

• For check providers, they could experience a fee from their bank if trying to cash a check. 

• If there are any questions from providers, we can share that “As a result of Automated Benefit Services suspected cyber event, payments that were in process have been reversed.  Once Automated Benefit Services system is back online, the payments will be reprocessed.”

• The list of impacted payments will be updated as soon as we receive it.  

• Please let leadership know if any providers call in complaining or are escalated. 

Important reminder for all associates:

• Payments inflight for ABS have been put on hold

• The PINs team is reviewing all impacted TINS for suspicious activity

• Once TINs have been reviewed by PINs and everything looks good the on hold payments will be released

• Portal users with Ascension or ABC emails domains have been suspended

• Currently the suspension is only to users of the Payer Portal.  Provider Portal access is still being reviewed.

Team,

We were made aware today of a potential cyber-attack at Ascension Automated Benefit Services (ABS), a subsidiary of theirs, is a Zelis client for both Price Optimization and Payments Optimization.

Out of an abundance of caution, Zelis has disconnected Ascension’s/Automated Benefit Services’ access to Zelis’ network. Zelis has diligently reviewed all systems and there are no indications that Zelis systems have been negatively impacted at this time.

Client-facing teams: Please do not communicate proactively at this time. For verbal response to inquiries only, please use the following talking points. No emails should be sent with this information.

• We are aware from general media monitoring that Ascension/Automated Benefit Services shut down their systems due to a suspected cyber event.

• Out of an abundance of caution, Zelis has disconnected Ascension’s/Automated Benefit Services’ access to Zelis’ network.

• Zelis has diligently reviewed all systems and there are no indications that Zelis systems have been negatively impacted at this time.

• We will provide necessary updates regarding Zelis services as information becomes available.

Important reminder for all associates: Known cyber security events present opportunities for fraudsters. All associates should stay vigilant about possible phishing, smishing, and cyber threats that can come through our channels – especially via mobile and email. Thank you for your diligence.

Dummy portal has a new password!! Please take note the password has changed to the dummy portal. 

https://uat1-provider.zelispayments.com/

Username: Trainer1

Password: Password1234567!

There has been an update with Zelis’ IVR. When providers call in, they now have the option to OPT-OUT of an invitational VCC account! 

In the Status History window, in the Modified By column, you will see TWILIO IVR - Opt-Out

This means the caller chose the option from the IVR before they were connected to you AND it should also automatically convert those invitational VCCs into paper checks. This means less work for us! You’ll just confirm they are set to receive paper checks and the VCCs have also started the process to convert to a check.

Disposition would be: Payments - Payment Still Processing

Reminders from Zelis:

• 835s are NOT an option for Check Providers. The Implementation team stated that some providers are being given 835 options and a clearinghouse added but not enrolled in a product. Please remember this is NOT an option. The provider must be enrolled in a product to have that benefit.

• The CARE line will be available again for warm-transfers starting tomorrow 5/1. Reminder that no more than 2 attempts are fine (this is a warm transfer) but then please create a work item.

• The CHC line is open still from 9am-5pm temporarily. Please remember to transfer those calls to (ZP_CHC_EPAYMENT) line. (Change Healthcare is set to reconnect as a working Clearinghouse as early as next week. More to come for confirmation) - see Breaking News 4/23/2024

• Reminder for the agents that we should be using the phrase “Suspicious activity” instead of “Fraud” when handling these issues with providers. (Request from the PINS team) - see Breaking News 4/24/2024

An issue has been reported for some Zurich payments.  A number of the payments are stuck in a “queued for payment” status.  The implementation team is working to resolve the issue as quickly as possible, but we may see an influx in calls from providers looking for funds.  Since the payments are in a queued status, they will not be visible by the provider in the portal.

Talking Points for points when a provider is calling to discuss either an unrecognized ACH credit or a letter or email relating to an ACH fee refund.

Globe Life has requested that they approve all provider requested reversals.  As a result, Globe Life has been added to the special handling payer dropdown on the ACH Reversal form.  Once a request is submitted the PPO ticket will be routed over to the CXM for handling with the payer.

Hey everyone! Internal is kicking our butt with these surveys scores. We've always been the best and lets keep it that way. An easy fix for everyone, I personally have been including this change on my calls so you're not alone, but if you feel like your callers had a good experience with you, use this new outro!

"Thank you for calling into Zelis. If you wouldn't mind, we do have an after call survey on your experience today. If you've opted into it, I'll get you transferred over. Have a wonderful day!"

QA will be listening to these calls its better to ask people that you know are happy then waiting for that ONE unhappy person to leave a score and that's all you have. Just reminding them at the end of the call and asking is an EASY way to get scores rolling through. Let me know if you're needing any help!