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How to explain payments to patients in your medical practice 

Patient payments explanation is essential for your medical practice. As a physician, your primary focus is providing quality healthcare to your patients. However, it is equally crucial to ensure that your patients clearly understand the medical billing process.   

According to a Mad*Pow research report, 61% of patients are confused by their medical bills. Another finding from the survey is that patients try to figure out bills on their own or just ignore them. Also, most of these surveyed patients identified providers or their billing department as the root cause of their frustration and errors.   

For medical practices, a good patient payment process can help collect every dollar your practice has earned, maximizing cash flow and optimizing your workflows to deliver an outstanding patient experience. Also, it fosters trust, reduces confusion, and creates a more transparent and patient-centric billing experience.  

Five strategies to explain payments to patients  

1. Start with open communication  

Establishing open communication from the outset is essential. During the initial patient visit or when scheduling appointments, your front desk staff can explain the billing process briefly and inform patients about the importance of understanding their financial responsibilities.   

Your front desk is one of the most critical roles in your medical practice. They play a massive part in helping patients better understand their plans and balances and enhancing processes that can help you reduce your denials and improve how you collect your payments.   

Read more about the importance of your front desk staff and how you can improve their processes in our blog Improve your front desk processes with these best practices.

Encourage patients to ask questions, providing them with comfort and confidence in discussing financial matters with your practice.  

2. Use simple language  

According to Policygenius, 96% of Americans don’t understand basic health insurance terms such as deductible, coinsurance, copay, and out-of-pocket maximum.  

Avoid using complex medical jargon or billing terminology when discussing patient payments. Use simple language that patients can easily comprehend. Ensure that your explanations are concise while covering all relevant aspects of the billing process.  

3. Provide a written explanation  

Supplement verbal explanations with a written breakdown of patient payments. In the document, be transparent and let patients know exactly what they will be responsible for paying at the time of service and what they may be accountable for, post-insurance claim adjudication. 

To help with this, offer a comprehensive document that outlines:  

  • Cost of services  
  • Insurance coverage  
  • Applicable copays and deductibles  
  • Any potential out-of-pocket expenses  

A written explanation allows patients to review the information at their own pace and refer to it whenever necessary.   

4. Discuss insurance coverage  

According to a Bend Financial survey, more than half of Americans are confused by health insurance. This confusion about health insurance costs Americans money and prevents many from getting the care they need. In the survey, respondents felt capable of navigating the healthcare system generally but less clear on navigating health insurance.  

Discuss the patient’s insurance coverage and any potential limitations or restrictions. Ensure that patients understand the difference between in-network and out-of-network services and the importance of seeking referrals when required. Also, inform them of their responsibilities in terms of copayments and coinsurance.  

5. Offer financial counseling  

Provide financial counseling to your patients who might need help understanding their balances. This can allow you to guide patients through the billing process, help them understand their financial obligations, and explore payment options available.   

Financial counseling can particularly benefit patients with financial difficulties or high deductibles. However, due to the administrative burden in medical practices, this financial counseling can be hard to achieve.  

According to a Forbes survey, 18% of providers report high patient call volumes is a significant pain point for their revenue cycle teams. Outsourcing this process can be a good option.   

At Health Prime, we can help!  

Health Prime’s Patient Payments Call Center (PFS) is the point of contact for all your patients regarding their medical billing services. Our bilingual agents will explain to patients their balances, help them make payments, handle refund requests, answer insurance-related questions, update insurance information, and more.   

We offer “balance reminder” phone calls so your patients know they have a balance with your office. They can pay or set up a payment plan before the bill is sent to collections.  

Also, outsourcing your patient collections is a great way to reduce your staff’s administrative burden and ensure you get paid for your work. Health Prime’s medical billing solutions allow you to maximize your patient collections and increase cash flow.   

Contact us at [email protected]. Our team will set up a meeting to discuss how we can maximize your revenue by cutting costs, saving time, and collecting more!     

Subscribe to the Health Prime blog. Stay tuned to all the latest updates, learn how to improve your medical practice, and ensure you are getting paid for your work.     



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