Healthcare Payments Firm Zelis Buys Sapphire Digital

Healthcare payment company Zelis has announced an agreement to acquire Sapphire Digital, a platform for provider selection, patient access, price transparency and digital consumer navigation for healthcare, according to a press release.

“There is a clear need in the market for innovative price transparency solutions and digital navigation tools, now more than ever given the requirements for payers laid out in the No Surprises Act and Transparency in Coverage rule,” said Zelis Chief Revenue Officer Patrick O’Keefe in the release. “We believe Sapphire’s platform is unmatched in the industry, as evidenced by its significant member reach and impressive roster of leading health plans, TPAs and self-insured employers.”

The acquisition will help customers more readily “harmonize the complete healthcare payment process by pricing, paying and explaining healthcare,” Zelis CEO Amanda Eisel said in the release.

The acquisition will help Zelis streamline operations by “integrating Zelis’ payments and communications capabilities with Sapphire’s market-leading consumer navigation tools,” Eisel added in the release.

Sapphire Digital CEO Kyle Raffaniello said in the release that the companies “have been tackling some of healthcare’s most intractable challenges.”

In 2019, Zelis merged its payment systems with those of RedCard Systems to create a healthcare optimization platform.

Read more: RedCard, Zelis Merge to Optimize Healthcare Payments

The platform planned to use the companies’ technology to price, pay and explain claims. The companies together worked with 700 payer clients, which included the top five national health plans along with around 600,000 providers.

Then-CEO Doug Klinger said the purpose was “to deliver deeper electronic penetration, best-in-class claim cost savings performance and a transformational billing and payments experience, all for the benefit of payers, providers and consumers.”

Joe DiMartini, then-CEO of RedCard, said the partnership combined “the three critical activities along the payment value chain: the payment data platform or software ‘brain’ to manage and communicate payment data, a highly attractive payment network and payment execution technology, and proprietary processes and expertise to organize every step required to efficiently and effectively take a complete payment file from start to finish.”