Why Carriers Need a Modern Payments Platform in an Interconnected World

In July 2024, the world experienced one of the largest cyber disruptions in history. A flawed update to a widely-used security platform led to the failure of more than 8 million devices, affecting every industry from aviation to banking to health care and costing roughly $1 billion.

The event highlighted the importance of strong cyber security and cyber resilience in an interconnected world. Outages and breaches will continue to happen, but organizations need to be able to bounce back as quickly as possible, while ensuring the security of their private data.

In the world of insurance, cyber resilience is a particular challenge as many carriers still operate on outdated legacy systems. Attempting to adapt these systems to work with multiple other parties and platforms within the claims ecosystem naturally introduces vulnerabilities.

“All companies should be re-evaluating what they are doing to keep their systems and data secure,” said Leah Silver, VP Business Solutions – Payments, Zelis. “It boils down to looking at your vendors. Not all vendors are created equal in how they stand up their systems and safeguard data. Are they holding themselves to high standards as it relates to security protocols? Are your redundancy programs fail safe? What have they learned from the recent cybersecurity attack, and how are they ultimately improving their processes internally to make themselves more resilient?”

With data coming in and out from multiple parties, it helps to have a centralized hub, managed through tight security infrastructure, to keep everything streamlined and to apply consistent protections across all data streams.

Benefits of a Modern Payment Platform

Leah Silver, VP Business Solutions – Payments, Zelis

Collecting and issuing payments creates a large area of exposure for carriers. Engaging with multiple parties and the sensitive nature of financial data make payment processing a vulnerable spot in terms of cyber security. It also represents an area of inefficiency, with many payers still utilizing paper checks. Digitizing and centralizing payment processes can help payers not only tighten security, but also reduce costs associated with time-consuming paper checks.

“Paper processes are riskier and check fraud is prevalent within the industry. Even the process of enrolling for electronic payments — whether it’s an attorney, a claimant or a provider — often involves filling out a paper form. You must plug in your bank account information and then send it off into the ether in hopes that, it won’t be accessible by someone who wants to take advantage of your information for fraudulent use,” said Matthew Lungen, SVP, Ancillary Business at Zelis.

“The goal is to eliminate paper checks and enable payees to enroll in electronic payments securely and confidently.”,” Silver said. “Getting away from paper processes and leveraging digital disbursements can reduce both cost and risk. Streamlining into a single source solution hub that’s managed through tight frameworks and security infrastructure will allow for Payers to take advantage of the efficiencies of a modern payments platform and focus on their core competencies.”

Adopting a centralized platform also lightens the load for a payer’s IT department, sparing the work of continually updating old systems and working to secure integrations.

In the workers’ comp and health care industries in particular, modernized and streamlined payments yield benefits for providers as well.

“Within the workers’ comp space, medical providers require many different variables as it relates to how they manage their payments and receivables,” Lungen said. “They often are dealing with multiple payers. So creating a single electronic highway to the provider and making the experience more aggregated really lessens the burden on providers and can strengthen the relationship between payer and provider. It also means providers can spend less time on reconciliation and more time on patient care.”

A centralized data hub also makes things easier for adjusters. The ability to see the status payments and how they are being dispersed among multiple payees makes the adjuster’s work more efficient.

Markers of a Secure Platform

Matthew Lungen, SVP, Ancillary Business at Zelis

A payer should look for several factors in a digitized payment platform provider. One is compliance with regulatory requirements. Second is multi-layered permission management, ensuring that no single user has access to all information. Third is an in-house security team dedicated to ensuring security and compliance across multiple vendors.

“The Zelis Advanced Payments Platform (ZAPP) acts as a centralized hub where all claims and payment information can live. It’s the connective tissue, so the payers can send us the data, and we can normalize that data to bring it up to par for today’s standards. They can then leverage our platform outside of their legacy systems to be able to manage all things payments and communications,” Lungen said.

“We also have the advantage of being a 100% proprietary platform,” said Silver. “Where others outsource certain capabilities, we have our own redundancy measures, our own cybersecurity team, our own risk mitigation team. Everything is done within our firewall, which puts us in a strong and secure position.”

While ZAPP was originally designed to streamline transactions in healthcare and the workers’ comp space, it can also help property & casualty payers stand out from their competitors in a digital world. As more payers adopt centralized data platforms, integrations will become easier and efficiencies maximized.

“The biggest players are starting to digitize, reduce cost and become more efficient,” Silver said. “We saw it in health care, and we are seeing it now as some carriers, TPAs, and property & casualty payers take advantage of solutions that will make them much more nimble. The bottom line is you must digitize to stay competitive, without sacrificing security.”

To learn more, visit https://www.zelis.com

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Zelis. The editorial staff of Risk & Insurance had no role in its preparation.

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and consumers. This platform serves more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs, Property and Casualty Payers, and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.