Zelis Healthcare

Zelis Healthcare Overview

Company Headquarters: US

Founded: 1995

Workforce: ~1,000

Company Working: Zelis Healthcare is a healthcare technology company that offers a comprehensive suite of healthcare cost management and payments solutions to healthcare payers, providers, and consumers. The company's offerings include network analytics, claim repricing, payment integrity, and electronic payments solutions. Zelis Healthcare's digital payment processing solutions are designed to simplify and streamline the payment process for healthcare payers, providers, and consumers. The company's electronic payments platform enables healthcare providers to receive payments from payers in a fast, secure, and reliable manner. This platform offers multiple payment options, including virtual credit cards, ACH payments, and check payments.

Zelis Healthcare's electronic payments platform also provides real-time payment tracking, automated payment reconciliation, and robust reporting and analytics capabilities. This helps healthcare providers to improve their cash flow, reduce administrative costs, and enhance their overall financial performance. In addition to its digital payment processing solutions, Zelis Healthcare also offers a range of other healthcare cost management solutions, including network analytics and claim repricing. The company's network analytics solutions help payers to optimize their provider networks and improve their overall network performance. Its claim repricing solutions help payers to reduce their healthcare costs by ensuring that claims are priced accurately and fairly. Zelis Healthcare is a major player in the digital payment processing market for healthcare. The company's comprehensive suite of healthcare cost management and payments solutions makes it a valuable partner for healthcare payers, providers, and consumers alike. Its advanced technology and focus on customer service have helped it to establish a strong reputation in the healthcare industry. Furthermore, with the acquisition of Payspan, the largest healthcare network in the U.S., the company provide payment automation services that improve administrative efficiency, meet regulatory requirements, and enable payers and providers to manage new reimbursement strategies. They bring together healthcare expertise with proven financial services technology to empower a new generation of healthcare economics.

Strategy

Zelis Healthcare's key strategy is to provide comprehensive healthcare cost management and payment solutions that help payers, providers, and consumers reduce costs and improve financial performance. The company focuses on developing advanced technology and providing exceptional customer service to differentiate itself from competitors in the healthcare cost management and payments space. Zelis Healthcare also seeks to expand its product offerings and geographic reach to increase its market share and revenue. To achieve this, the company has formed partnerships and collaborations with other healthcare technology companies and has made strategic acquisitions to enhance its capabilities and competitiveness. Additionally, Zelis Healthcare has a strong focus on building and maintaining long-term relationships with key customers, as a significant portion of its revenue comes from a limited number of clients. Overall, the company's key strategy is to provide innovative solutions that deliver value to its customers and drive growth for the company.

Company Snapshot

1,000

Employees

1995

Founded

US

Headquarters

SWOT Analysis

Strengths

Comprehensive suite of healthcare cost management and payment solutions
Strong reputation in the healthcare industry
Experienced and knowledgeable management team

Weaknesses

Limited geographic reach, as the company's operations are primarily focused on the United States.

Opportunities

Growing demand for healthcare cost management and payment solutions as healthcare costs continue to rise.

Threats

Intense competition in the healthcare cost management and payments space, which may lead to pricing pressures and reduced margins.

Key Developments

Date	Approach	Development
November 2022	Acquisition	Zelis, announced the completion of its acquisition of Payspan, a leader in healthcare electronic payment and reimbursement automation services. The U.S. healthcare system is complex, with disjointed and often challenging financial processes. Delivering a better experience hinge on the efficient and seamless delivery of payments among insurers, providers, and consumers. The combination of these two companies, unifying an expansive array of capabilities in the new Zelis Advanced Payment Platform SM will improve the healthcare financial experience for all.
September 2022	Acquisition	Zelis, announced the completion of its previously announced acquisition of Payer Compass, one of the healthcare industry’s leading providers of reimbursement and claims pricing, administration, and processing solutions. The acquisition will enable Zelis to evolve and expand our best-in-class solutions for out-of-network healthcare services for clients.
October 2019	Merger	Zelis Healthcare (“Zelis”) and RedCard Systems (“RedCard”) announced the successful completion of their previously announced merger. The combined company provides market-leading technology and solutions to over 700 payers and 600,000+ providers to price claims, pay claims and explain claims, all at enterprise scale on a claim-by-claim basis. The merger was supported by Parthenon Capital, a growth-oriented private equity firm and an existing investor in both Zelis and RedCard, and by Bain Capital Private Equity and Bain Capital Ventures.

Product Offering

Zelis Healthcare
- Digital Payment Processing Application
- Digital Payment Processing Services

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