Savings Solutions

We focus on finding meaningful, high-performing solutions that will benefit every industry and community we serve.

Claims Cost Containment

Zenith American partners with the industry leader who utilizes an integrated approach to generate the highest level of savings on every claim powered by superior technology and the industry’s most dedicated and experienced clinical team.  
 
CLAIMS EDITING
Deploys leading-edge technology and high touch interventions to generate fast, accurate, customized editing that's 100% compliant with ever-changing guidelines.
CLINICAL BILL REVIEW & AUDIT
Combines proven algorithms with a team of clinicians who perform chart audits on high dollar and specialty medical claims. The approach includes a full scope clinical and financial analysis with adherence to plan policy requirements and the assessment of claim itemization to ensure billing compliance standards.
OUT-OF-NETWORK SOLUTIONS
Combines coding & clinical intelligence with cost analytics to generate optimal savings on every claim and ensure the most appropriate reimbursement for care.
 

Payment Solutions

Zenith American Solutions is the administrator of choice for clients requiring a high level of expertise in all aspects of financial accounting and regulatory reporting.  Our financial administration services are designed to meet the specialized needs of our clients.
 
  • Electronic payments save clients print and postage costs associated with provider payments
  • Faster, more secure payment options
  • Turn-Key implementation
  • No work flow change
  • End-to-End automated reconciliation process
  • CORE Phase III Compliance
  • Backed by high-touch provider and payer support
 

Telemedicine

Convenient 24/7 access to online visits with board-certified doctors, counselors, psychiatrists, and dermatologists.
 
  • Partnered with the nation’s largest telehealth network
  • Visit a doctor in minutes 24/7 through our mobile app, online and by phone 
  • Get prescriptions (when appropriate)
  • Quality care on your schedule
  • Private and secure consultations
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Payroll Audit

Let us handle your payroll auditing so you can rest assured your multi-employer benefit plans are working effectively and funds are being paid correctly. We follow AICPA guidelines to ensure our clients are collecting the proper amount from employees. 

How does it work?

  • Contact the employers to schedule payroll audits, including if necessary, assistance from Union Business Representatives or Fund Attorneys
  • Compare and review payroll records to confirm employer compliance with their Collective Bargaining Agreements
  • Work with the employer to determine audit outcomes, including employee identification, preliminary results, and invoices.
  • Prepare and issue invoices to employers and monitor payment status, including past due statements, and demand letters.
  • Utilize and coordinate with Fund Professionals, Business Agents, and Attorneys to resolve employer disputes (if any) and collections.
 

Consumer-Driven Health Care

We have the tools to make your role in managing consumer-driven health care accounts easier, and your employees happier. Whether you are offering a Flexible Spending Account, Health Reimbursement Account, Health Savings Account, Retirement Reimbursement Account or a combination of these accounts, our robust health administration tools allow your employees to manage their own benefits.

We strive to help minimize costs where we can, our consumer-driven health management tools not only help you fight rapidly rising health insurance costs but adds depth to your employee benefits packages.

Benefits available to our clients:

  • Full administration of substantiation
  • Link to claims files
  • Debit cards
  • Member portal updated in real time
  • Member mobile app
 

Subrogation and Recovery

 
Zenith American Solutions partners with the industry leaders to offer an innovative solution for our clients that identifies more opportunities to recoup funds and recover more on a per case basis. Our subrogation and recovery service saves with:
 

Subrogation and Third Party Reimbursements

Advanced detection technology & multifaceted investigation techniques identify more recovery opportunities.  Pairing with superior claim recovery specialists, paralegals, and attorneys result in unrivaled mastery of law and increased Fund recovery.

Overpayment Recoupment

Regardless of the cause, excess payments are pursued by overpayment recovery specialists, a team dedicated to recovering funds from providers.  

Class Actions, Toxic Tort and Product Recalls

Claims are run through a second proprietary system to specifically identify instances where a participant utilized medication, products, or was exposed to toxic substances, that are now featured in some form of class action, recall, or litigation – presenting opportunities to recoup funds for the plan.

Litigation & Attorney Retention

In instances where litigation is absolutely necessary to recoup funds, options are presented and efforts are conducted to secure legal representation for their benefit plan client in the proper jurisdiction and venue.
  

Contact Us Anytime

For more information please contact ProductSolutions@Zenith-American.com