provideroutreach.zelis.com Open in urlscan Pro
45.60.76.152 Public Scan

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URL:
https://provideroutreach.zelis.com/
Submission: On July 24 via manual (July 24th 2024, 9:40:38 am UTC) from US — Scanned from GB

Form analysis
1 forms found in the DOM

<form _ngcontent-fsx-c59="" novalidate="" class="ng-untouched ng-pristine ng-invalid">
  <div _ngcontent-fsx-c59="" class="d-flex justify-content-between">
    <div _ngcontent-fsx-c59="">
      <h6 _ngcontent-fsx-c59="" class="po-ink-blue"> Provider Outreach </h6>
    </div>
    <div _ngcontent-fsx-c59="" class="po-ff">* Required</div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col"><!----><!----></div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col po-ff"> Please enter the code found in the correspondence received, then the Facilty Name OR Provider First and Last Name. </div>
  </div>
  <div _ngcontent-fsx-c59="" class="row form-group">
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="uniqueRecord" class="po-ff">Enter Code*</label><input _ngcontent-fsx-c59="" formcontrolname="uniqueRecord" maxlength="11" pattern="[A-Za-z0-9\-]*" type="text"
        class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----><small _ngcontent-fsx-c59="" class="form-text-sm0 text-muted"> Please refer to correspondence for case sensitive code</small></div>
    <div _ngcontent-fsx-c59="" class="col">
      <p _ngcontent-fsx-c59=""></p>
    </div>
  </div>
  <div _ngcontent-fsx-c59="" class="row form-group">
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="facility" class="po-ff">Facility</label><input _ngcontent-fsx-c59="" type="text" formcontrolname="facility" maxlength="50"
        pattern="[A-Za-z0-9\s\Q$&amp;+,:;=?@#|'.^*()%!-\E]*" class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----></div>
  </div><!---->
  <div _ngcontent-fsx-c59="" class="row form-group">
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="firstName" class="po-ff">Provider First Name</label><input _ngcontent-fsx-c59="" type="text" formcontrolname="firstName" maxlength="20"
        class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----></div>
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="lastName" class="po-ff">Provider Last Name</label><input _ngcontent-fsx-c59="" type="text" formcontrolname="lastName" maxlength="45"
        class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----></div>
  </div><!---->
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col">
      <hr _ngcontent-fsx-c59="">
    </div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col">
      <h6 _ngcontent-fsx-c59="" class="po-ink-blue"> Please enter your information below. </h6>
    </div>
  </div>
  <div _ngcontent-fsx-c59="" class="row form-group">
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="firstNameSigner" class="po-ff">Your First Name*</label><input _ngcontent-fsx-c59="" type="text" formcontrolname="firstNameSigner" maxlength="20" pattern="[A-Za-z\- ()']+"
        class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----></div>
    <div _ngcontent-fsx-c59="" class="col"><label _ngcontent-fsx-c59="" for="lastNameSigner" class="po-ff">Your Last Name*</label><input _ngcontent-fsx-c59="" type="text" formcontrolname="lastNameSigner" maxlength="20" pattern="[A-Za-z\- ()']+"
        class="form-control ng-untouched ng-pristine ng-invalid" style="font-family: AvenirLTProMedium;"><!----></div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col"></div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col text-left po-ff"><strong _ngcontent-fsx-c59="">I verify the provider information.</strong></div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col">
      <hr _ngcontent-fsx-c59="">
    </div>
  </div>
  <div _ngcontent-fsx-c59="" class="row">
    <div _ngcontent-fsx-c59="" class="col"><button _ngcontent-fsx-c59="" type="submit" class="button btn-sm float-end"><!----> Login </button>
      <div _ngcontent-fsx-c59="" class="float-end">&nbsp;&nbsp;&nbsp;</div><button _ngcontent-fsx-c59="" type="button" class="btn btn-sm btn-outline-secondary float-end">Clear All</button>
    </div>
  </div>
</form>

Text Content

PROVIDER OUTREACH PORTAL

PROVIDER OUTREACH

* Required

Please enter the code found in the correspondence received, then the Facilty
Name OR Provider First and Last Name.
Enter Code* Please refer to correspondence for case sensitive code



Facility
Provider First Name
Provider Last Name

--------------------------------------------------------------------------------

PLEASE ENTER YOUR INFORMATION BELOW.

Your First Name*
Your Last Name*

I verify the provider information.

--------------------------------------------------------------------------------

Login
   
Clear All

FAQ
WHY DOESN’T MY PASSWORD WORK?

The Provider Outreach Portal is used for provider directory validation and is a
separate site from Zelis.com. Your password will not work on this website.
WHY DOESN’T THE CODE AND/OR NAME PROVIDED ALLOW ME ACCESS?

The code must be in all caps including hyphens.
The name must be populated exactly how it appears on the email requesting
provider validation.
WHO IS ZELIS?

Zelis is a network provider and payer company.
Your contract with Zelis could be listed under one or more of the following
products – HFN, PPOPlus, PlanCare America, 4Most, or Stratose.
WHY AM I GETTING THIS REQUEST SO OFTEN?

As per federal and state requirements, provider demographic data changes
frequently throughout our provider networks therefore we need to ensure our
provider directory reflects accurate information.
We will be requesting provider directory validations on a quarterly basis.
WHO CAN ASSIST WITH PROVIDER INQUIRES SUCH AS FEE SCHEDULES, CREDENTIALING
STATUS, AND ADDING NEW PROVIDERS?

Dental provider questions Dentalppo@zelis.com
Medical provider questions Providercontact@zelis.com
WHO CAN ASSIST WITH PAYMENT RELATED QUESTIONS?

Call or email our Client Service Team.
1-877-828-8770 or ClientService@zelispayments.com
8 a.m. to 7 p.m. ET, Monday-Friday
HOW DO I TERMINATE A PROVIDER THAT IS NO LONGER IN PRACTICE?

Log into the Provider Outreach Portal with the code and provider or facility
name provided and select the location to be termed. There is a “delete” button
at the bottom of the screen. Press delete and submit.



NEED MORE HELP?

Email: GH_provideroutreach@zelis.com
Phone: 1-678-846-2680
Fax: 404-250-4886

 * Privacy Policy
 * Terms of Use
 * © Zelis Healthcare

provideroutreach.zelis.com Open in urlscan Pro 45.60.76.152 Public Scan

Form analysis 1 forms found in the DOM

Text Content

provideroutreach.zelis.com Open in urlscan Pro
45.60.76.152 Public Scan

Form analysis
1 forms found in the DOM