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Health plans must modernize payments systems to keep their provider base

How insurers can meet the needs of today's providers

4 min read



Retaining a robust provider base poses an ongoing challenge for health plans. As both parties deal with intensifying financial pressures, payers strive to improve provider satisfaction—and payment processes play a key role.

Providers often grapple with administrative burdens, including aging technology, inefficient workflows and complex billing processes and documentation requirements.1 This leads to frustration and burnout of administrative staff, leaving providers to pick up the slack; provider administrative tasks have increased 15 percent in recent years.2

A Forrester study of provider leaders found more than half agreed that claims and payment processing delays are harming their business, and more than 80% said improving both payment and claims efficiency is important or mission‑critical to their success.1 As a result, 78% of providers aim to reduce patient burden related to claims processing, and 85% strive to implement payment systems that meet both patient experience goals and business needs.

Payers are strategically positioned to alleviate friction in the provider experience. There is a strong incentive to improve the financial process to meet increasing demands for transparency and guidance in healthcare financial solutions. Health plan leaders should embrace a modernized, single-platform payments system that streamlines the payment process, allows providers to receive their payments sooner and enhances overall satisfaction among providers and their patients.

Meeting the needs of today’s providers

Today’s providers expect efficient, timely digital payments and expect the payers they work with to be tuned in to their operational needs. One way that a modernized payment system helps retain providers is that it offers multiple payment options and methods.

Providers should be able to choose the payment method that best suits their operations, facilitating a smoother transaction process. This flexibility improves payment efficiency and demonstrates that the payers they work with incorporate cutting-edge technological advancements.

Increased automation also reduces the number of improper denials, speeding payments and eliminating sources of provider abrasion. This in turn will create a smoother experience for members and helpsproviders retain more patients.

Additionally, advanced payment systems will be tightly secured, better protecting providers from fraud, theft and compromised patient data amid increasing cyberattacks that target the healthcare industry.

Guiding providers on digital transformation

In addition to multiple payment options, a modernized system consolidates essential information such as claims and remittance data, benefits information and provider payment details into one accessible platform. This combined approach simplifies the administrative burden on providers, allowing them to spend less time on claims and administrative tasks and more time on providing quality care to patients.

Seventy percent of providers want solutions with both payment and claims management tools that feed into one data source, reducing administrative workload and providing better insights.1 But while providers know they need to modernize their payments systems, many don’t know how to make the shift, and efforts they undertake on their own often fall short.

When payers partner with a payments network that actively guides providers in modernizing their payments systems, the positive impact extends beyond streamlined processes. It reduces employee burnout and stress on resources.

“A modern payments system delivers the data needed for providers to do their day-to-day work and make administration easy,” says Eugene Hahn, senior vice president for sales at Zelis.

Providers can then redirect their focus from navigating complex payment systems to delivering exceptional care. Every moment that providers are able to spend with patients, rather than on administration, improves their experience.

In today’s healthcare landscape, retaining a satisfied provider base is a strategic imperative. By addressing the challenges posed by a lack of clarity in payments and claims, health plan leaders can position themselves as facilitators of positive change. As the industry increasingly moves toward digital transformation, health plans have the opportunity to lead the industry toward a future of efficiency, collaboration and improved patient care.

How ZAPP can help

By consolidating payments processes into a single, modernized platform, payers can better meet the needs of their provider base and support them in digital transformation. With the Zelis Advanced Payments Platform (ZAPP), payers get modernized payment delivery at scale with a large network of providers that is constantly growing. Zelis provides dedicated resources to help with ongoing enrollment support and training while the ZAPP payment platform reduces fraud exposure, accelerates sustainability initiatives, reduces waste and improves operational efficiency.

Visit to learn more about how ZAPP can modernize the healthcare financial experience for everyone.


  1. The Importance Of Reducing Friction In Healthcare Providers’ Financial Journeys. Forrester Research, Inc. May 2023.
  2. The CAQH Index Report. 2022.