HealthEdge and Zelis Announce Strategic Partnership to Streamline Healthcare Payments

HealthEdge and Zelis have announced a strategic partnership aimed at modernizing the healthcare payment landscape. The collaboration will leverage HealthEdge’s next generation core administrative processing system (CAPS) and the Zelis Advanced Payments PlatformSM (ZAPP) to enhance the efficiency, accuracy, and transparency of healthcare payments.

HealthEdge’s HealthRules® Payer (HRP) offers transformational outcomes and business agility for all types and sizes of health plans, built to adapt to evolving consumer demands, regulatory changes, and competitive opportunities. By combining the strengths of HRP with the ZAPP platform, the partnership delivers payment processes that maximize member cost savings and streamline payer and provider operations.

“Health Plans have many challenges, including expanding to new markets, adopting value-based care payment arrangements, meeting evolving industry regulations, and more,” says Alan Stein, Chief Product and Strategy Officer at HealthEdge. “Plans must maximize member cost savings and streamline the payment process to make it more efficient.”

Building upon an existing adjudication integration partnership, this collaboration aims to reduce friction and enhance the member and provider experience. The integration of HealthEdge’s modern cloud-based platform with Zelis’ single-hub payments and data solution streamlines workflows, minimizes custom code, and supports a seamless payment process. This ensures seamless payment interactions between health plans, providers and members, improving satisfaction and reducing friction.

“ZAPP is the industry’s first integrated payments and communications platform delivering digital conveniences and experiences that benefit payers, providers, and members,” says Yusuf Qasim, President, Payments Optimization at Zelis. “In partnership with HealthEdge, we can help resource-constrained health plans modernize their payments experience and seamlessly scale into new markets and reach providers and members without further implementation.”

With the integration of HealthEdge and Zelis systems, health plans will benefit from more efficient and less complex data exchange, reducing administrative burden. The out-of-the-box integration—enabled by advanced technologies and industry expertise—paves the way for an automated payment process that can deliver more value to health plans, providers, and members.