Zelis Skims 3% — Switch to No-Fee EFT

Need the right portal or enrollment route? Use the Zelis ePayment Center login guide and ePayment Center vs Payments Network enrollment comparison. Newly covered payer routes: MVP Health Care; Select Health; Devoted Health; Banner Health Plans; AvMed.

If your payment notice names InstaMed, start with the InstaMed payer-payment EFT guide to check that vendor’s enrollment route.

If a payer pays you through Zelis, you're probably losing 2–3% of every payment to a fee you never agreed to. Bomi gets you off virtual cards and onto no-fee direct deposit so your full payment lands in your account.

You open what looks like an insurance payment from Zelis and find a virtual MasterCard — a single-use card number you're told to “redeem” by running it in your merchant portal. Run it, and a credit-card processing fee (typically 2–3%) comes straight out of your payment. Below is a real example.

What Zelis is

Zelis is a payments vendor that health plans hire to deliver claim payments and remittances. Hundreds of payers route their provider payments through it. On the Zelis Network, the electronic options it offers (the virtual card, and a “fast” EFT) carry a fee that's deducted from your payment; the only no-fee default it advertises is a paper check. That's the setup that quietly costs practices 2–3%.

You have a right to no-fee EFT — here's the law

Here's what most practices don't realize: under the federal electronic-payment standard for health care (adopted through Section 1104 of the Affordable Care Act and the rules at 45 CFR 162.1601–162.1602), every health plan must, on your request, pay your claims through the standard ACH bank transfer — the ordinary, no-fee electronic deposit. CMS has been explicit: a health plan, or a payment vendor like Zelis acting for it, cannot require you to accept virtual credit card payments, and if you ask to be paid by the standard EFT instead, the plan must comply.

CMS guidance also says no fee should attach to that standard EFT itself. The 2–3% you see deducted is a charge for an optional value-added service (the virtual card, or an expedited “fast” EFT) that you can decline. It is not a toll you have to pay to get paid electronically.

One honest nuance: this is a right to a no-fee standard transfer on request, not a blanket ban on every fee. A 2–3% charge for an optional expedited service you actually chose is allowed; what a plan or vendor cannot do is force the fee on you as the price of electronic payment. If one won't honor a clean standard-EFT request, the recourse is a complaint to CMS through its Administrative Simplification (ASETT) system.

How to switch: opt out, then enroll payer by payer

There's no single national switch — you do it one payer at a time. For each payer paying you through Zelis:

• Opt out of the virtual card. Tell Zelis you don't want virtual-card payments. Don't run the card in the meantime — running it is what triggers the fee.

• Enroll in no-fee standard ACH EFT. Many payers route a no-fee ACH option through a payer-sponsored Zelis “ePayment Center” that is separate from the fee-based Zelis Network. You enroll with your practice TIN/EIN, NPI, and bank account, and choose to receive your remittances (835/ERA) electronically.

• If a plan resists, escalate. A plan or its vendor cannot condition electronic payment on a fee. If they won't honor a clean standard-EFT request, file a CMS Administrative Simplification (ASETT) complaint naming the health plan.

It's tedious, payer-specific paperwork, which is exactly why most practices never do it and keep losing the percentage.

How Bomi helps

Bomi runs this for you. We opt your practice out of Zelis virtual cards, enroll you in the no-fee standard ACH EFT for each payer that uses Zelis, and set up your electronic remittances so payments post cleanly. You stop losing 2–3%, and you don't touch the paperwork.

This article is general information, not legal advice. The protections described come from federal CMS guidance and your right to request the standard EFT transaction; enforcement runs through the CMS complaint process, and specifics can change. Confirm your options with the payer and CMS before relying on them.

Want us to get the virtual-card fees off your payments? Reach us here https://www.bomihealth.com/#contact.

Payer-by-payer guides

Specific payers that pay through Zelis:

• Quest Behavioral Health virtual-card fees and EFT

• Auxiant virtual-card fees and EFT

• Allegiance virtual-card fees and EFT

• HealthLink virtual-card fees and EFT

• UMR virtual-card fees and EFT

Frequently Asked Questions

Can I refuse Zelis virtual card payments?

Yes. Under federal CMS guidance, a health plan or its payment vendor (like Zelis) cannot require you to accept virtual credit card payments. You have the right to request the standard ACH EFT instead, and the plan must comply. The 2–3% virtual-card fee is for an optional service you can decline.

Is the Zelis fee illegal?

Not exactly — and it's worth being precise. Federal law guarantees you a no-fee standard ACH EFT on request; it doesn't flatly ban every fee. A fee for an optional expedited or virtual-card service you chose is allowed. What a plan or vendor can't do is force that fee on you as the only way to be paid electronically. If one does, you can complain to CMS through its ASETT system.

Do I have to switch each payer separately?

Yes. EFT enrollment is payer-by-payer — there's no single national opt-out. For each payer that pays through Zelis, you opt out of the virtual card and enroll in that payer's no-fee standard ACH EFT (often via a payer-sponsored Zelis ePayment Center).

What if I already ran some virtual cards?

Those already cost you the fee, but going forward you can still opt out and switch to no-fee EFT. The fee only hits when the card is run, so stop running new ones while you switch.