Patient billing and collections
Patient responsibility keeps growing and it's the hardest money to collect. We handle statements, plans, and questions in a way that doesn't cost you the patient.
The problem this fixes
High-deductible plans have shifted a large share of revenue onto patients, and patient balances collect far worse than insurance balances — collection rates on commercially insured patient responsibility have fallen sharply, and large balances collect worst of all.
Practices are also reluctant to push. The person who owes you money is the person you'll see next month.
And the operational cost lands on the wrong people. When statements are unclear, the calls go to the front desk, which is already checking patients in. Time that should be spent on registration accuracy and point-of-service collection is spent explaining an explanation of benefits, which quietly makes the next month's billing worse as well.
What goes wrong when this is done badly
Four failure modes we see repeatedly, and each one is a process problem rather than an effort problem.
Statements that need explaining
Most patient billing disputes are comprehension problems. A statement that does not show what was done, what insurance paid, and why the balance remains will generate a phone call instead of a payment.
Collecting nothing at the desk
A copay not collected at check-in becomes a statement, a reminder, a phone call, and frequently a write-off. It is the same dollar, collected at ten times the cost.
No payment route in the message
A statement that requires a phone call during business hours to pay is a statement designed to age. Every message should carry a way to pay it immediately.
Escalating before communicating
A collections referral on a patient who never understood the bill costs the balance and the relationship. Outreach should be exhausted first, and the practice should approve every referral.
What's included
Every item below is a deliverable, not a capability statement.
Clear, itemised patient statements
In plain language, showing what insurance paid.
Multi-channel delivery
Mail, email, SMS [CLIENT INPUT — confirm channels].
Online payment portal
So paying is not a phone call.
Payment plan setup and management
Structured, tracked, and followed up.
Point-of-service collection guidance
For the front desk, per patient.
Good-faith estimates and No Surprises Act support
[VERIFY — confirm current scope with counsel].
Patient billing enquiry support
By phone and email, answered by a person.
Financial hardship and charity policy application
Applied to your own written policy.
Pre-collection outreach
Before any agency referral.
Collections agency coordination
As a last resort, and only with your approval.
How it works
- 1 Statement design We make the statement readable: what was done, what insurance paid, what is owed and why.
- 2 Delivery Sent on your chosen channels with a payment route in every message.
- 3 Support Patient questions answered by a person, not a phone menu.
- 4 Plans and hardship Payment plans and hardship policy applied where the balance warrants it.
- 5 Escalate last Pre-collection outreach is exhausted before any agency referral, and only with your explicit approval.
What a readable statement has to answer
| The patient asks | The statement must show | What happens without it |
|---|---|---|
| What was this for? | The service, in plain language, with the date | A phone call to the front desk |
| Did my insurance pay anything? | Billed amount, allowed amount, plan payment and adjustment | The patient assumes they were not covered and disputes |
| Why do I owe this? | Deductible, copay or coinsurance, named as such | The balance is treated as an error rather than a bill |
| Is this the final amount? | Whether other claims for the visit are still processing | Partial payment, then confusion at the next statement |
| How do I pay? | An online route, a phone route and a postal route on every message | The balance ages while the patient means to deal with it |
| What if I cannot pay it now? | That payment plans exist and how to ask for one | Silence, then an ageing balance and an awkward next visit |
What you get back
- Patient balance ageing reported alongside insurance A/R
- Payment plan status by patient
- Enquiry volume and common questions reported back to you
- A written escalation path you approve before it is used
Who this is for
- Practices with a high-deductible or self-pay heavy patient mix
- Practices collecting little at the point of service
- Practices whose front desk fields billing questions all day
- Practices unwilling to use an aggressive collections approach
What we measure
The numbers this service actually moves. You see all of them weekly, in your own system, with the benchmark alongside.
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Patient balance ageing Reported alongside insurance A/R rather than buried under it. Patient responsibility behaves differently and ages worse, and blending the two hides both.
-
Self-pay collection rate Collected against billed patient responsibility. Large balances collect worst, so we report it banded by balance size rather than as one number.
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Point-of-service collection rate What was collected at the desk against what was collectable there. Every dollar here removes a statement, a phone call and an ageing balance.
-
Enquiry volume and reason How many patients called, and what about. A spike in "what is this charge" is a statement design problem, and it is fixable.
Benchmark ranges are sourced from MGMA and HFMA MAP Keys. MedBil's own figures are published only with a stated measurement window, per specification section 12.7.
Where this matters most
The specialties where this part of the cycle carries the most risk and the most recoverable revenue.
Start with your own numbers
We measure your denial rate, A/R ageing and net collection rate against industry benchmarks before you commit to anything. You keep the analysis either way.
- 90 days of claims data, no patient identifiers needed
- A written analysis, not a sales deck
- No contract, and no obligation to proceed
- Client results published with a stated measurement window, once available
Questions about patient billing & collections
Will you send my patients to collections?
Only with your explicit approval, and only after our own outreach sequence is exhausted.
Can patients pay online?
Yes.
Do you handle patient billing questions directly?
Yes — patients reach a person, not a menu.
Related
Where this connects to the rest of the cycle.
Eligibility & Benefits Verification
Coverage and benefits confirmed before the visit, not after the denial.
See eligibility verificationPrior Authorization Services
Auth requests submitted, tracked, and escalated so procedures aren't delayed.
See prior authorizationMedical Billing & Coding Audits
Retrospective and pre-bill audits that find both compliance risk and missed revenue.
See billing & coding audits