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Patient Billing Services

With high-deductible plans now common, a real share of practice revenue is owed by patients rather than payers, and patients pay more readily when they understand the bill. We send clear statements, answer billing questions, set up payment plans and follow up consistently, within the rules that govern patient billing.

  • Statements that show what insurance paid and why the patient owes the rest
  • A patient billing line for questions
  • Payment plans and reminders before any collections step
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Patient billing services included

  • Statements after adjudication

    Patients are billed only after insurance has processed the claim, so the balance reflects the payer's actual decision.

  • Readable statement design

    Each statement shows the service, what was billed, what insurance paid or adjusted, and the reason the remaining amount is the patient's.

  • Billing questions answered

    Patients can call or message about their bill and get an answer from someone who can see the claim. Support is available Monday to Friday by phone and email.

  • Payment options

    Online payment and payment plans set up under rules you approve. Online payment uses the portal your practice management system provides.

  • Follow-up cycle

    A defined sequence of statements and reminders, ending with a final notice before any account is referred onward.

  • Patient refunds

    Patient overpayments and credit balances researched and refunded promptly rather than left on the account.

The patient statement cycle

  1. Step 1: Insurance first

    Payer payments and adjustments are posted so the patient balance is correct.

  2. Step 2: First statement

    A clear statement goes out with payment options and a contact for questions.

  3. Step 3: Reminders

    Follow-up statements and reminders follow on a set schedule. Statements and reminders typically follow a 30-day cycle.

  4. Step 4: Offer a plan

    Patients who cannot pay in full are offered a payment plan before the account goes any further.

  5. Step 5: Final step under your policy

    Accounts that remain unpaid are handled exactly as your financial policy says: hold, write off or refer to an agency.

Practices that hand off patient billing

  • Front desks answering billing calls

    Billing questions pull staff away from patients who are in the office.

  • Specialties with large patient balances

    Procedures that fall under deductibles produce larger statements and more questions.

  • Pediatric and family practices

    The patient and the person responsible for the bill are often different, which needs careful guarantor handling.

Rules that shape patient billing

The federal No Surprises Act bans surprise balance bills in many out-of-network situations, and gives uninsured and self-pay patients a way to dispute a bill that comes in at least $400 above the good faith estimate they received (45 CFR 149.620). Statements and estimates have to be consistent with each other for that reason.

Collection agencies are covered by the Fair Debt Collection Practices Act. Federal law, including that Act and the Fair Credit Reporting Act, also governs how medical debts in collection are collected and reported to credit bureaus, so we check the current rules before any account is referred. Automated calls and texts about balances need the right consent under the Telephone Consumer Protection Act. Statements also follow HIPAA's minimum necessary standard, so they disclose only the health information the billing purpose actually needs.

Official sources: CMS: No Surprises Act, medical bill rights (external site), eCFR: 12 CFR 1006.2, debt collector definition (Regulation F) (external site), eCFR: 47 CFR 64.1200, call and text consent (external site), eCFR: 45 CFR 164.502, minimum necessary (external site), eCFR: 45 CFR 149.620, patient-provider dispute resolution (external site), CFPB: medical debt collection and credit reporting (external site)

Frequently asked questions

When should a patient get their first statement?

After the insurance claim has been processed and posted. Billing patients before then often means sending a corrected statement later, which causes confusion and calls.

What if a patient disputes their bill?

The account is put on hold while the claim is reviewed. Many disputes turn out to be a coverage or coding question that can be fixed with the payer; others need an explanation of the deductible or coinsurance.

Who is responsible for a minor's bill?

The guarantor, usually a parent or legal guardian, as recorded at registration. Getting the guarantor right at the start avoids statements going to the wrong household.

Can we send unpaid balances to collections?

Yes, if your financial policy allows it. Practices decide when, or whether, an account is referred; we follow that policy and make sure each patient received the full statement cycle first.

Do you call or text patients about balances?

We contact patients by mailed statement, email and phone. Any automated calls or texts are only sent with the consent the law requires.

Related services and specialties

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Make patient balances easier to collect

Talk to us about your current statement process, or start with a free audit of your patient A/R.

Request a Free Billing Audit