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About digital patient billing and payment
Patient billing and payment is the ability of individual patients to access their billing information, understand their coverage and financial responsibility, and complete payment.
Out-of-pocket costs for patients are rising, and health systems have seen corresponding increases in bad debt and administrative costs related to collections. On average, providers only collect about 40 percent of outstanding patient balances. As the proportion of revenue attributable to patients continues to grow, effective management of patient receivables is essential to protect health system margins.
Digital patient payment and billing solutions can improve patient financial engagement with greater visibility into their financial obligations, streamlined billing information, and flexible payment capabilities. Health systems that successfully implement digital patient billing and payment solutions can drive liquidation of patient balances and help create and support positive margins for health systems. AVIA Marketplace estimates that each percentage point of lift in digital payments translates into approximately $2 million in net collections.
What many of the leading solutions offer:
- Self-service out-of-pocket cost estimators
- Digital statements
- Statement consolidation
- EOB reconciliation
- Flexible payment options
About this report
The Top Patient Billing and Payments Companies Report is intended to provide healthcare leaders with a broad view of patient billing and payment and showcase standout companies and solutions with proven market traction. Users can view quick summaries to help them identify which solutions might meet their needs and visit AVIA Marketplace to access detailed profiles and verified client lists, compare solutions, and generate Match Scores to narrow their selections.
This report is powered by AVIA Marketplace data, and inclusion is based on the number of verified health system clients listed for each company on AVIA Marketplace. Due to confidentiality agreements, vendors may not always be able to provide full lists of clients.
AVIA Marketplace's top patient billing and payment companies
R1 RCM’s suite of end-to-end revenue cycle solutions combine patient-friendly features and self-service functionality with intelligent automation and tools to maximize reimbursements and monitor performance across the entire revenue cycle. Self-service tools guide patients through scheduling, registration, financial clearance, and intake, which shifts administrative tasks away from staff and supports efficient and accurate billing processes. Patients can choose payment options with consolidated accounts for households, and R1’s proprietary propensity-to-pay algorithms help providers offer personalized payment plans.
With its portfolio of mobile-optimized patient payment solutions, Experian Health helps health systems offer flexible payment options, with tools to assess propensity to pay and connect patients with financial assistance and personalized payment plans. Health systems can securely connect any form of payment with the PaymentSafe solution, utilize a text-to-mobile experience to view bills and make mobile payments, and access their accounts and explore financial counseling and assistance with PatientSimple. The Patient Financial Clearance solution automates pre-service or point-of-service screening and efficiently connects patients with financial assistance and Medicaid enrollment opportunities.
Cedar dramatically improves the consumer financial experience in healthcare by simplifying bill payment, providing increased transparency into costs, and offering flexible and affordable paths to balance resolution. With a modern technology platform that connects providers, payers and the healthcare ecosystem, Cedar empowers consumers with an optimized journey across pre-registration, insurance verification, cost estimate and billing touch points. The result is increased uptake of digital solutions and meaningful engagement, helping health systems and physician groups lift financial performance, operate more efficiently and deliver a best-in-class consumer experience.
Waystar delivers some of the market’s most innovative and popular revenue cycle management solutions with its Hubble AI and robotic process automation platform. Hubble supports pre-service eligibility verification and generates easy-to-understand estimates that patients can access on mobile or desktop screens. Waystar’s patient payment solution integrates with existing systems and offers personalized engagement and omni-channel communication, flexible payments, and automated reconciliations. Health systems can maximize patient revenues with the Advanced Propensity to Pay solution, which stratifies accounts and helps providers determine which accounts should be written off or sent to collections.
Upfront's patient payment solutions significantly increase patient payments (4X in 10 days) and balance collections (up to 24% for balances due 120+ days) while reducing statements costs up to 50% with its digital omnichannel and bi-directional communications. These communications leverage psychographic, demo/socioeconomic, behavioral and patient-reported data to tailor content to each patient based on their individual motivations. Digital statements can be scheduled and delivered through digital channels to reduce paper and postage and includes tracking to monitor open and click-through rates and online payments. Automated payment reminders are delivered through text, email or interactive voice response call to smoothly link patients to payment portals or connect them with live assistance.
RevSpring designed its array of financial engagement solutions to provide the right type of engagement to individual patients at the right time. The Payment Touchpoints solution engages patients in the billing and payment process and provides easy access to the appropriate payment option. Statements and reminders flow from a central hub and are deployed based on patient preference, behaviors, and desired outcomes. RevSpring also offers tools to turn data into actionable insights, so health systems can easily assess propensity to pay, offer optimized payment plans, and generate strategic communications with heat map and gaze path-based design.
Sift expands on basic propensity-to-pay scores with its predictive analytics that provide actionable insights about patient responsibility and create a clearer picture of which patients will pay and when. AI-powered tools segment patients and generate individualized recommendations to help health systems reach out to patients in the right way with the most impactful content. Sift’s C-Suite intelligence tools leverage propensity-to-pay analytics and other data to provide powerful insights into patient populations, with 360 degree views of patient behavior and utilization trends.
Luma Health’s Patient Success Platform goes a step beyond patient engagement and provides information and tools to help them meet their financial responsibilities in a fragmented and complicated healthcare system. Health systems can deliver automated reminders and collect payments with digital forms, one-on-one chat or through the EHR with flexible payment options. Real-time insurance eligibility verification helps reduce financial risk for patients and providers, and Luma offers guided workflows that auto-fill payer data to streamline the billing process.
Relatient offers serious return on investment with its SaaS-based patient outreach solutions, which include messaging and payment tools that reduce staff workload and increase patient revenue. With the MDPay solution, providers can collect payment information before billing and implement auto-billing for small balances. Text message payment links help eliminate cumbersome app downloads and passwords–patients simply verify their birth year and payment, and MDPay auto-fills the rest with previously captured data. Patients receive email or text notifications as bills become available, and providers receive status updates when balances are collected.
Health systems can boost collections, streamline payment workflows, and drive electronic payments with Change Healthcare’s flexible patient billing and payment solutions. Account statements include research-backed content to improve engagement among target demographics, with easy-to-understand cost breakdowns and multiple payment options to enhance billing transparency and facilitate easier payments. Change’s SmartPay solution makes it easier to pay upfront, both in person and by phone, or patients can make one-time or recurring payments with Consumer Pay Online. The interactive Phone Pay option provides 24/7 self-service access to a multi-lingual, menu-driven payment system.
A single percentage point increase in patient revenues can translate into millions of dollars for health systems, which means that a personalized, patient-centered payment experience is vital. Flywire’s analytics-driven payment platform matches patients with the right payment options for their unique needs, building its accuracy with each data capture. Providers can initiate payment plans on pre-service estimates and post-service balances, and multiple accounts can be consolidated into a single easy-to-understand statement. Flywire’s open architecture allows integration with all current solutions and workflows, and flexible payment and cash management options mean that patients can submit payments through their preferred methods–no alternate workflows required.
Other notable patient billing and payment companies
Find your new patient billing and payment solution.
Out-of-pocket costs for consumers are growing at a rapid rate, which leads to a corresponding increase in financial risk for health systems. Intelligent digital patient billing and payment solutions inform and engage patients throughout their care journeys with better information about their insurance coverage, cost transparency before care is delivered, and convenient, flexible payment options. Health systems can more accurately predict which patients will pay and direct their resources appropriately.
Visit AVIA Marketplace to explore the companies listed in this report and thousands of other digital health companies and solutions. You’ll find verified client lists, use cases, differentiators, and more to help you streamline the vendor selection process and identify companies that can fulfill the unique needs of your health system.
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