Despite widespread smartphone adoption and the consumerization of payments across nearly every industry, the patient responsibility payment workflow has changed surprisingly little in the last 20 years.
Many medical billing teams still manually run monthly statements from the PMS or EHR, spend hours stuffing envelopes (or outsource statements to a print and mail provider), and then wait for payments to trickle in. Unpaid balances roll into the next statement cycle, and then the next, each time requiring another costly mailing. To attempt to speed things up, practices have added QR codes to their paper statements or “Pay Now” buttons to their websites. But those additions alone have done little to change collection performance. After three or four months of statements, staff often turn to phone calls to chase delinquent balances. It is labor-intensive, expensive, and difficult to scale.
Meanwhile, some payments arrive through multiple channels. Patients call with questions and pay over the phone. Others mail a check. A few scan the QR code and pay online. Those payments often land in separate systems, leaving staff to check each one, reconcile transactions against patient accounts, and post payments back to the PMS or EHR to keep balances current. QR codes may increase the share of payments made digitally, but they don't do much to remove the manual work around the payment. J.P. Morgan’s 2026 Healthcare Payments report found that 63% of providers still primarily collect through manual, paper-based processes, and 70% need two or more statements to collect a patient balance in full. The issue is not simply how patients pay, it’s the manual, paper-first workflow behind the payment. With patient responsibility payment rates ranging between 45-55% for many providers, practices should explore all options to reduce the cost to collect and increase collection rates.
Modernizing the workflow
What if practices could relatively easily modernize and automate much of this patient responsibility billing workflow to reduce cost and increase collections without replacing existing technology? Imagine a world where instead of mailing first and waiting for a response, a digital statement can be delivered by text and email as soon as a balance is ready. The patient gets a direct link to a clear, mobile-friendly payment experience, one that supports cards, digital wallets, HSA/FSA cards, and self-service payment plans. They can view their statement without navigating a cumbersome portal login, get immediate AI automated answers to routine billing questions, and get efficiently connected with a human when more complex issues arise. When they pay, the payment can be automatically matched to the correct balance and posted back to the PMS/EHR, all without someone downloading reports and reconciling transactions one at a time. This is not just a better payment experience that patients will appreciate, it’s a better operating model: less paper, fewer manual touchpoints, faster follow-up, and more staff time focused on the accounts that genuinely need attention.
Moving beyond paper statements
While a QR code on the paper statement or a simple "Pay Now" button on the website provides access to digital payments, it falls short of modern patient expectations and does not solve the core operational challenges associated with the typical paper-based patient responsibility workflow. Streamlining workflows requires an end-to-end solution: automated outreach, transparent and easy to access digital statements, 24/7 self-service support, modern and flexible payment options, and automated posting. By starting with digital and removing manual touchpoints, practices can reduce costs to collect by over 60% and boost collection rates by 2–3x, all while delivering the seamless experience today’s patients expect.
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