Medicare AdvantageAdministrativeHigh impact
Provider Alert: Payment Platform Transition from Payspan to Zelis
Ambetter·IA·Claims & Billing
Effective date
Nov 6, 2026
We identified it
Sep 5, 2026
Summary
Effective November 2026, provider claim payments and remittance information will transition from Payspan to the Zelis payment platform. This is a payment delivery and access change only—reimbursement rates, claims adjudication, and payment methodology remain unchanged. The billing team must verify current payment setup, confirm electronic payment methods, and coordinate enrollment before staggered conversion dates by line of business.
Action Required
Immediately: Billing, revenue-cycle, finance, treasury, and IT teams must begin reviewing current payment setup now. Identify the payment and remittance method used for each tax identification number and pay-to location. Before the applicable conversion date for your line of business (Wellcare Medicare: Nov 6, 2026; Ambetter Marketplace: Nov 13, 2026; Iowa Total Care Medicaid: Dec 4, 2026; Wellcare Dual Eligible: Dec 10, 2026): Complete enrollment communications and select electronic payment method (ACH/EFT preferred to avoid paper check delays). Verify and confirm bank-account details, remittance-delivery preferences, clearinghouse information, and payment administrator email address. Allow sufficient time for banking verification and account activation before conversion. After conversion date: Reconcile deposits, payment methods, and 835 files promptly and report missing or unexpected items to support. Failure to enact may result in payment delays if paper checks are issued instead of electronic payment.