By Ryne Natzke, Chief Commercial Officer and GM, TrustCommerce, a RevSpring Company
LinkedIn: Ryne Natzke
LinkedIn: RevSpring
Hospitals are losing revenue well before a bill ever reaches a patient. The standard billing process waits until after care ends, a claim is processed, and a balance is finalized to have any real conversation about cost. By then, the patient has moved on and has no context for the number in front of them. The result is a confused patient and a structurally slower path to payment, built on surprise balances, inbound billing calls, and slower collections. Evolving the process means changing how and when payment conversations happen, not just cleaning up what happens after. Evolving the process starts with changing how and when conversations around payments happen in the patient experience.
Back-office billing creates avoidable inefficiencies
The payment journey should start at the point of appointment scheduling. Organizations that wait until the end of the process to introduce cost and payment expectations are building friction into their own revenue cycles.
Organizations should be discussing cost early, setting expectations before care is delivered, and creating simple steps for patients to pay their bills when the time comes, like adding a card on file in advance. When that foundation is in place, patients better understand what they owe and can pay with minimal effort, enabling providers to collect faster.
A lot of this friction comes from disconnected systems. Scheduling, billing, and payment posting often run on separate platforms that don’t communicate, so staff end up manually matching payments to accounts and chasing down where a balance stands. Clear visibility requires connecting systems so payment status updates automatically as a patient moves through the visit. Connecting the full payment lifecycle, from the first touchpoint through the final deposit, lets organizations avoid chasing unpaid or partially paid bills.
The communication layer is where collections break down
Many billing problems start with confusing communications. A patient could get a bill referencing a denied claim, with no clear explanation of what was denied or the reasoning behind it, leaving patients with a lack of understanding of their balance and unlikely to pay. Every touchpoint with a patient, from scheduling to reminders to check-in, is an opportunity to share cost information. Payment communications must be transparent.
When patients seek care, they know that there will be a cost associated with it. What’s challenging for most patients is that they often don’t know how much they owe or why, which is vastly different from other purchase situations. That ambiguity makes the process feel harder than it needs to be.
Healthcare providers need to give patients context earlier on in the care journey to make payment a simpler process. The earlier a patient’s financial responsibility becomes part of the conversation, the more likely a provider gets paid.
When it comes to billing, empathy is a critical part of the equation. Medical expenses are rarely budgeted for in the same way as other purchases. Patients don’t choose when they need care, and that makes billing fundamentally different from a retail transaction. The barrier usually isn’t unwillingness to pay, but rather the confusing and unpredictable nature of healthcare costs. According to RevSpring’s Cost of Confusion Report, 50% of consumers say they’ve cut back on care because of costs. Reducing friction and fear, rather than escalating pressure, helps move balances, and helps patients stay out of debt while still getting the medical care they need.
Aligning access, revenue cycle, and the digital front door
Digital-first billing is now a baseline expectation, with research finding that 82% of consumers are comfortable using apps and patient portals to manage their health. Leading organizations are meeting patients there with solutions like text-to-pay that includes a clear balance and a card on file lets a patient confirm payment in seconds.
That simplicity depends on back-end integration. Eligibility checks, cost estimates, and payment options need to flow into the same digital channels a patient already uses, so a visit reminder serves as a chance to prepare for or complete payment before the claim is finalized.
Staff training on how to talk to patients about bills and when to bring it up is also significant, but it’s often overlooked. Not every touchpoint is self-service and patients communicate with front desk staff at the point of check in and on the phone to ask questions about their care. Staff should be able to easily access balance information and be empowered to give the patient an opportunity to pay at each time they communicate with them.
Ultimately, health systems that treat access, revenue cycle, and the digital front door as one connected system instead of three separate departments will see the impact on their bottom line.
The cost of waiting to bring up bills
Health systems that treat billing as an integral part of the care experience instead of a closing function will have fewer calls tying up front desk staff and faster collections without added pressure on patients. That takes mapping where cost conversations currently happen, connecting scheduling, billing, and payment processes and training front desk and phone staff to raise payment naturally. These changes are the difference between billing costing patients and providers alike, and billing that supports the care experience.