AblePay Health

About AblePay Health

AblePay Health, founded in 2016, operates as a financial technology company in the healthcare sector, addressing the mounting issue of out-of-pocket medical expenses for patients and revenue cycle challenges for providers. The company was established by John Fistner, a seasoned healthcare executive who, during his time as a hospital CFO and COO, identified significant inefficiencies in patient billing and collections. This firsthand experience with the financial strain on both patients and healthcare systems prompted him to create AblePay as his third startup venture in the healthcare space. Based in Bethlehem, Pennsylvania, the company has seen significant growth, earning a spot on the Inc. 5000 list of fastest-growing private companies in 2022.

The core of AblePay's business model is to serve as an intermediary between medical providers and patients after insurance has processed a claim. For patients, the company offers a no-cost membership that provides discounts of up to 13% on their remaining medical bills, along with flexible, interest-free payment plans. This service is designed to work with any primary health insurance, including Medicare, making it widely accessible. Patients enroll, receive an AblePay card, and present it along with their insurance card at participating providers. AblePay then settles the bill with the provider promptly—within 14 days—and the patient repays AblePay under their chosen savings and payment terms. The business generates revenue by retaining a portion of the discount negotiated with the providers, who benefit from reduced collection costs, accelerated payment, and a higher collection rate. Case studies show providers can see a significant increase in their collection rates and revenue per patient.

The service portfolio extends beyond just payments. A key feature is patient advocacy; AblePay's team assists members with billing questions and disputes, aiming to simplify the often-confusing healthcare billing process. The company serves a diverse client base, including individual patients, employers who offer it as a no-cost benefit, and a growing network of healthcare providers, from large health systems like Lehigh Valley Health Network and St. Luke's University Health Network to smaller specialty offices. Initially focused on Pennsylvania and New Jersey, the company has expanded its network to include providers in Ohio, Kentucky, Indiana, and Georgia. All member interactions, including bill viewing and payments, are managed through a secure, HIPAA-compliant online portal.