The U.S. healthcare funds system is tormented by fragmentation, delays, and administrative waste—25% of healthcare prices go towards guide 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 information 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 turn into ZAPP—the Zelis Superior Fee Platform. What started as an answer to digitize checks for third-party directors developed into a strong funds infrastructure now serving each payers and now suppliers. In an interview, Qasim talked about among the challenges the healthcare trade faces in navigating healthcare funds. He additionally mentioned how Zelis is uniquely reworking the way in which 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 in the end transformative.”
The dearth of constant, dependable information 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 simple to reply these.”
Launched in 2024 because the trade’s first built-in healthcare funds and communications platform, ZAPP addresses this head-on. The platform digitizes, consolidates, and delivers funds and information 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 concentrate on follow organizational progress and affected person care slightly than troubleshooting.
The push by regulators in 2010 to require payers to supply some type of digital fee providing supplied Zelis with an enormous tailwind, in accordance with Qasim. Across the similar time, CMS put out extra steering round digital funds.
“They had 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 way in which, ensure that each our payer and supplier purchasers knew they’d a selection in how funds had been obtained.”
The affect of ZAPP is placing: Of their work with one Arizona-based Built-in Supply Community (IDN), claims that when 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 information 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 pace—it’s about making collaboration doable.
Streamlining the fee course of, dashing it up, coupled with offering correct and safe information 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 middle,” Qasim warned. “As we lean into AI, we should construct belief via transparency—not let algorithms turn into black containers.”
For suppliers hesitant about digital funds, Qasim urges an open mindset. He believes that collaborative automation can get rid of the burdens they face in the present day.
Zelis’s transformation of healthcare funds isn’t only a expertise improve—it’s a mindset shift. By making information extra accessible, workflows smarter, and funds frictionless, it’s serving to suppliers and payers concentrate on 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 tough—but it surely doesn’t should be chaotic. With platforms like ZAPP, readability is lastly inside attain
Photograph: BlackJack3D, Getty Photographs
