AblePay Health

What AblePay Health does

AblePay Health is a private healthcare fintech company founded in 2016 by John Fistner, a former hospital CFO and COO, and headquartered in Allentown, Pennsylvania. The company operates a cloud-based patient financial engagement platform that functions as a secondary payer in the healthcare billing ecosystem, processing claims via standard 837/835 EDI formats so providers can integrate AblePay without changing existing billing vendors. Patients enroll at no cost, present an AblePay card at the time of service, and receive up to 13% savings on out-of-pocket medical expenses with flexible payment terms of 1, 3, 6, or 12 months and zero interest. The platform includes a member-facing portal for bill management, a provider claims interface, and in-house billing advocacy services.

AblePay's business model is transaction-based: the company negotiates discounted rates with healthcare providers in exchange for guaranteed, risk-free payment within 14 business days, then earns the margin between the contracted amount paid to providers and the full amount collected from patients (plus a $35 failed transaction fee). The company assumes 100% of patient collection risk. As of November 2022, AblePay served over 40,000 members across 75+ hospital partnerships spanning 32 states, and had secured endorsements from 21 state hospital associations by its 10th anniversary in June 2026.

The company sells through a multi-channel go-to-market: direct enterprise sales to hospitals, health systems, and physician groups; channel partnerships with health insurance payers and brokers who offer AblePay as a voluntary member or employee benefit; and self-serve patient enrollment via an online portal. The company has appeared on the Inc. 5000 list for four consecutive years (2022-2025), raised $11.28M in funding in April 2024, and operates with a leadership team of founder/CEO plus senior vice presidents spanning Operations, Business Development, Marketing, Provider Sales, Provider Success, a Chief Developer, and a VP of Finance.

Name

AblePay Health

Legal name

AblePay Health, LLC

Website

https://www.ablepayhealth.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

11–50 employees

Short description

AblePay Health operates a cloud-based secondary-payer platform that processes patient medical bills via standard 837/835 EDI, offering insured patients up to 13% savings and flexible 0%-interest payment terms while guaranteeing providers risk-free payment within 14 days. The company serves hospitals, health systems, patients, payers, and brokers across 32 U.S. states.

Ownership category

akta.pro rank

Product category

Healthcare Patient Financing

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Patient Financial Engagement (Estimates, Billing Presentment, Payments) (HLACAEAI)

akta.pro secondary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

Keywords

• Patient financial engagement
• Medical bill discounts
• Healthcare payment plans
• Secondary payer processing
• Medical billing advocacy

Headquarters

HQ city

Bethlehem

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Provider Discount Negotiation: AblePay negotiates discounted rates with medical providers in exchange for guaranteed, risk-free prompt payment. AblePay assumes all risk on patient collections. Providers receive payment at a contracted rate within 14 business days. AblePay funds its operations from the margin between what it collects from patients and the discounted amount paid to providers.
2. Failed Transaction Fees: A $35 failed transaction fee is charged when a patient's payment fails due to insufficient funds, invalid payment information, or other reasons. This is the only explicit fee mentioned in the terms of service.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels7 records

Core offering

AblePay Health operates a no-cost patient financial engagement program that functions as a secondary payer in the healthcare billing ecosystem. Members enroll for free, receive a card presented at participating providers, and gain access to discounts of up to 13% on out-of-pocket medical expenses plus flexible interest-free payment terms of 1, 3, 6, or 12 months. In exchange, AblePay pays providers a contracted discounted rate within 14 business days via standard 837/835 EDI integration, assuming all patient collection risk.

Product overview

AblePay Health offers a single, unified patient financial engagement platform centered on its no-cost membership program. The platform operates as a secondary payer, processing claims via standard healthcare EDI (837 and 835) and encompassing three core modules: the Member Portal for patients to manage and pay bills, a Provider Claims interface for submitting and tracking secondary claims, and in-house Billing Advocacy Services to help members navigate billing questions and disputes. The platform is insurance-agnostic and works alongside any primary health insurance plan.

Differentiator

Problem solved

Functional benefit

Products and services

• AblePay Health Patient Financial Engagement Program

Quantifiable outcome

• Patients save up to 13% on out-of-pocket medical expenses
• +7 more outcomes

Named customers28 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature5 records

Partnerships

Nine partnerships are on record, tiered minor and core.

• EnableCompminorGTM or Marketing Partner · 2 June 2026EnableComp co-hosted the Women's Revenue Cycle Leadership Reception with AblePay during the HFMA Annual Conference 2026 in National Harbor, Maryland. EnableComp helps over 1,000 hospitals recover $3 billion annually from complex claims.
• MedixminorGTM or Marketing Partner · 2 June 2026Medix co-hosted the Women's Revenue Cycle Leadership Reception alongside AblePay during the HFMA Annual Conference 2026.
• MDSminorGTM or Marketing Partner · 2 June 2026MDS co-hosted the Women's Revenue Cycle Leadership Reception alongside AblePay during the HFMA Annual Conference 2026.
• PennCreditminorGTM or Marketing Partner · 2 June 2026PennCredit co-hosted the Women's Revenue Cycle Leadership Reception alongside AblePay during the HFMA Annual Conference 2026.
• HBiZ / Health Business SolutionsminorGTM or Marketing Partner · 2 June 2026HBiZ/Health Business Solutions co-hosted the Women's Revenue Cycle Leadership Reception alongside AblePay during the HFMA Annual Conference 2026.
• Harrison Memorial HospitalcoreStrategic or Co-development Partner · 1 August 2022Harrison Memorial Hospital is a 61-bed hospital in Cynthiana, Kentucky, serving Harrison County and surrounding counties. The hospital has 17 physicians on its active medical staff and more than 100 consulting specialists. The partnership brings the AblePay model to Harrison Memorial's patients, providing savings on out-of-pocket medical costs and flexible payment options.
• Respiratory Specialists (Berks Schuylkill Respiratory Specialists Ltd.)coreStrategic or Co-development Partner · 2 June 2022Respiratory Specialists is a comprehensive pulmonary, asthma, and sleep medicine practice serving patients in Berks, Schuylkill, Carbon, and eastern Lebanon counties in Pennsylvania. The practice has affiliations with Tower Health and Penn State Health, providing physician coverage at Reading Hospital, Pottstown Hospital, and St. Joseph Hospital. The partnership enables AblePay access to patients through specialty physician offices.
• Healthcare Council of Western Pennsylvania (HCWPA)coreStrategic or Co-development Partner · 1 June 2022HCWPA is a nonprofit regional trade association representing acute and non-acute facilities, organizations serving individuals with intellectual and developmental disabilities, and specialty healthcare providers across 30 counties in western Pennsylvania and northern West Virginia. The partnership introduced AblePay's patient financial engagement program to HCWPA's member facilities.
• SRHO – The National AssociationcoreStrategic or Co-development Partner · 20 November 2020SRHO is a consortium of Strategic Regional Healthcare Organizations established in 2017, representing over 400 hospitals and healthcare systems. The strategic partnership brings the AblePay model to SRHO's member health systems across the United States. At the time of the partnership announcement, AblePay's network included 42 hospital campuses and over 1,100 specialty provider offices across 20 counties in Pennsylvania, New Jersey, and Ohio.

Scale indicators13 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• CareCredit (Synchrony Financial): Synchrony Financial's healthcare financing product offers patient payment plans for out-of-pocket medical, dental, and vision expenses. It is the dominant healthcare patient financing platform with provider acceptance networks and a promotional financing model that competes directly with AblePay's payment flexibility offerings.
• HealthPay24: HealthPay24 provides patient payment and billing solutions for hospitals and health systems, including estimates, payment plans, and financing options. It serves a comparable customer base and addresses similar patient financial engagement use cases.
• Cedar: Cedar is a patient financial engagement platform offering personalized billing, payment, and engagement experiences. It competes with AblePay for the patient affordability and provider revenue cycle use case, though with broader product scope.
• VisitPay (Waystar): VisitPay, now part of Waystar, provides patient billing, payment, and financing solutions to health systems. It is a direct competitor addressing the same patient financial engagement pain points as AblePay.
• AccessOne: AccessOne is a patient financing platform that partners with health systems to provide no-interest and low-interest payment plans for medical bills. It is a direct competitor in the patient financial engagement and provider revenue cycle space.
• ClearBalance: ClearBalance provides patient financing and recovery solutions to health systems, offering interest-free and interest-bearing payment plans. It directly competes with AblePay in the patient affordability and provider revenue cycle space, particularly among hospital systems.
• PayMedix: PayMedix offers healthcare payment solutions that consolidate medical bills and provide patients with affordable payment terms. It directly competes with AblePay's mission to make out-of-pocket medical expenses more manageable for patients while guaranteeing provider payment.

Emerging players

• Collectly: Collectly provides AI-powered patient billing and collections software for healthcare providers, focused on reducing outstanding patient balances. It overlaps with AblePay in the patient payment engagement category but takes a more software-only approach without assuming collection risk.
• EnableComp: EnableComp specializes in complex claims reimbursement for hospitals (workers' comp, motor vehicle, veterans) and is an adjacent revenue cycle partner. It co-markets with AblePay at industry events and serves overlapping hospital customers with complementary services.
• Cured: Cured is a digital patient engagement and communication platform for healthcare that includes payment-related features. It represents a newer entrant in patient financial engagement with broader CRM capabilities but less specialized focus on secondary-payer mechanics.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds3 records

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about AblePay Health