The U.S. healthcare funds system is stricken by fragmentation, delays, and administrative waste—25% of healthcare prices go towards handbook processes alone. Suppliers chase lacking funds and wrestle to reconcile claims throughout redundant portals. In the meantime, payers, who aren’t constructed to operate as banks, face inefficiencies and pissed off companions. The persistent disconnect between funds and knowledge has resulted in eroded belief and wasted assets for everyone within the system.
Yusuf Qasim, President of Zelis’s funds enterprise, co-founded Pay-Plus Options in 2011. After its acquisition by Zelis in 2019, Qasim helped construct what would develop into ZAPP—the Zelis Superior Fee Platform. What started as an answer to digitize checks for third-party directors developed into a sturdy funds infrastructure now serving each payers and now suppliers. In an interview, Qasim talked about among the challenges the healthcare business faces in navigating healthcare funds. He additionally mentioned how Zelis is uniquely remodeling the best way healthcare is operationalizing funds leveraging trendy capabilities.
“We knew the system wasn’t constructed for real-time effectivity,” Qasim defined. “We needed to transcend regulatory compliance and create one thing business-friendly, consumer-focused, and finally transformative.”
The dearth of constant, dependable knowledge and insights behind healthcare funds is a big detriment to suppliers, each by way of administrative burden and enterprise and income cycle insights. “The highest questions suppliers ask are: ‘When will I receives a commission?’ and ‘Why is that this declare caught?’” mentioned Qasim. “Proper now, the system doesn’t make it straightforward to reply these.”
Launched in 2024 because the business’s first built-in healthcare funds and communications platform, ZAPP addresses this head-on. The platform digitizes, consolidates, and delivers funds and knowledge from its rising community of greater than 550 payers. This, in flip, reduces a lot of the executive burden on suppliers related to healthcare funds and accelerates money circulate.
By automating tedious back-office duties, it empowers suppliers to give attention to apply organizational development and affected person care fairly than troubleshooting.
The push by regulators in 2010 to require payers to supply some type of digital fee providing offered Zelis with an enormous tailwind, in line with Qasim. Across the identical time, CMS put out extra steerage round digital funds.
“They have been beginning to set the baseline requirements. However we actually determined to take it a step additional,” Qasim shared. “We needed to make our platform not simply one thing that was pushed by regulation. We needed to be consumer-friendly and business-friendly and, alongside the best way, make it possible for each our payer and supplier shoppers knew that they had a alternative in how funds have been acquired.”
The affect of ZAPP is putting: Of their work with one Arizona-based Built-in Supply Community (IDN), claims that after took two months to course of now clear in simply two days. Digital fee quantity has doubled, and administrative waste has been slashed.
“The discount in value and complexity has made everybody happier,” mentioned Qasim. “Higher knowledge hygiene means fewer fee anomalies, quicker money circulate, and fewer guesswork.”
A few quarter of healthcare spending goes to administrative overhead. Fixing the fee piece isn’t nearly velocity—it’s about making collaboration attainable.
Streamlining the fee course of, dashing it up, coupled with offering correct and safe knowledge means fewer fee disputes, higher money circulate, and faster resolutions, which fosters belief and makes collaboration simpler, mentioned Qasim.
Requested what improvements in fee expertise Zelis envisions within the subsequent 5 years, he predicts the rise of agentic AI—autonomous packages that optimize decision-making for customers—and a world the place funds take hours, not days.
However with digitization comes duty.
“Cybersecurity should keep entrance and heart,” Qasim warned. “As we lean into AI, we should construct belief via transparency—not let algorithms develop into black containers.”
For suppliers hesitant about digital funds, Qasim urges an open mindset. He believes that collaborative automation can eradicate the burdens they face at this time.
Zelis’s transformation of healthcare funds isn’t only a expertise improve—it’s a mindset shift. By making knowledge extra accessible, workflows smarter, and funds frictionless, it’s serving to suppliers and payers give attention to what issues: delivering care.
And for sufferers? A extra seamless fee ecosystem means fewer billing errors, quicker authorizations, and a clearer expertise navigating the price of care.
Healthcare is difficult—but it surely doesn’t should be chaotic. With platforms like ZAPP, readability is lastly inside attain
Picture: BlackJack3D, Getty Pictures
