PayMedix

About PayMedix

PayMedix operates as a financial technology platform designed to address the complexities and rising costs associated with healthcare payments in the United States. The company is a division of Health Payment Systems (HPS), a Milwaukee, Wisconsin-based organization founded in 2008. PayMedix itself began over a decade ago as the financing arm of HPS and has since evolved to offer its solutions nationwide, compatible with any PPO or HMO network. The firm is led by CEO Tom Policelli, who joined in February 2021. Policelli brings extensive experience from co-founding and leading other healthcare companies like Minuteman Health and Averde Health, and has held roles at United Health Group and CIGNA Healthcare.

The core of PayMedix's business is to simplify medical billing for patients and guarantee payments for healthcare providers. It serves a multi-sided market, including patients, medical providers (hospitals and physician practices), employers, and third-party administrators (TPAs). For patients, PayMedix consolidates what are often numerous and confusing medical bills and explanation of benefits (EOB) statements into a single, easy-to-understand monthly statement called the SuperEOB®. This approach simplifies expense management and provides clarity on healthcare costs. For providers, the platform eliminates financial risk and collection costs by guaranteeing prompt payment for all in-network patient out-of-pocket charges. PayMedix takes on the responsibility of collecting the patient balance, effectively removing bad debt from the provider's books.

The company's business model generates revenue primarily by charging fees to healthcare providers, who benefit from reduced billing complexities and the elimination of collection risks. A smaller portion of revenue comes from fees charged to employers. Notably, the service is structured to be consumer-friendly, as PayMedix does not charge interest or fees to patients, offering them guaranteed, zero-interest credit lines up to their out-of-pocket maximum, regardless of their credit history. This model of underwriting the employer group rather than the individual patient aims to improve health equity by ensuring all employees can access care without financial deterrence. The company has processed over $5 billion in medical payments and recently enhanced its capabilities by acquiring TempoPay, a healthcare payments solution.