From Billing to Bank: Closing the Gap in Patient Payments

The Challenge: From Billing to Bad Debt

Every day, healthcare providers wrestle with the evaporating revenue hidden in patient responsibility accounts, a growing burden that drags on both financial performance and patient experience. In fact, across U.S. healthcare, patient collections have ballooned by 133% from 2011 to 2024, making them a primary concern for organizations striving to maintain healthy cash flow.

More than 58% of all third‑party debt collection in the U.S. stems from medical bills, an astonishing figure that illustrates how deeply “payment gaps” are embedded in the system. The resulting bad debt impacts providers and patients alike:

• Providers become de facto debt collectors, spending valuable time chasing payments instead of delivering quality care.

• Patients whether insured, underinsured, or self-pay face confusion over EOBs, surprise bills, and aggressive collection outreach, which often undermines their trust and willingness to continue care.

This broken cycle not only erodes healthcare finances but deters patients from seeking needed preventive services, leading to costlier downstream care and worsening outcomes.

The Solution: FinTech‑Powered Payment Models

FinTech and healthtech innovations are transforming the healthcare payment landscape giving providers a way out of the collections business and patients a more manageable experience.

How Modern Payment Models Work

Fintech platforms like Simplee, PayZen, Cedar, Salucro, and others implement a provider-first, patient-friendly payment approach:

• Upfront Payment Guarantee: the platform pays the provider immediately once claims are adjudicated.

• Patient Financing Plans: patients are offered flexible repayment schedules—often no- or low-interest, regardless of credit covering out-of-pocket max, deductibles, or co-pay obligations.

• Consolidated Billing Experience: instead of multiple confusing statements, patients get a single, simplified invoice summarizing all care making it easier to understand and act on.

Some of these platforms leverage AI-based underwriting (e.g., PayZen) to assess payment likelihood and personalize terms, or blockchain-enabled smart contracts to improve transparency and fraud prevention in claim processing.

Real-World Examples

• PayZen recently made headlines for purchasing medical bills upfront and offering interest-free payment plans up to 60 months. While providers get paid immediately, critics raise concerns about transparency and whether true charity-care discounts are bypassed for low-income patients.

• Simplee’s enterprise platform enables digital patient billing, estimation tools, and financing options. Hospitals using it have reduced collection costs and increased self-service payments significantly.

• Salucro helps providers integrate secure, flexible payment options directly into digital operations creating a retail-like experience where patients can pay or finance care within their portal or app.

• MDsave bundles procedures into upfront pricing and partner financing, eliminating surprise bills and simplifying the consumer-side experience.

Transformation: From Billing to Bank

Key Benefits of New Payment Models

1. Predictable Cash Flow: Providers receive payment upfront, improving balance sheet stability and enabling better resource planning.

2. Operational Efficiency: With fintech and integrated payment platforms, administrative teams spend less time on collections and more on patient care.

3. Improved Patient Experience: Transparent, consolidated billing and self-service options reduce confusion and stress. Patients report higher trust and loyalty when they can choose how to pay.

4. Reduced Bad Debt: By offloading repayment to third-party platforms, providers are no longer dragging aging receivables or denying care based on financial status.

Best Practices for Providers

• Adopt a digital-first financial approach: Implement self-service billing portals, online payment options, and cost transparency tools (e.g., Simplee, Veradigm Payerpath).

• Disclose payment models clearly: Ensure patients understand whether their account is sold to a third party (e.g., PayZen) and what financing terms apply especially low-income patients who may qualify for charity care.

• Integrate with your EHR and billing systems: Fintech platforms should sync with your revenue cycle management tools to reduce manual reconciliation and erroneous billing.

• Provide price estimates upfront: Use cost estimation tools to educate patients before services are rendered and reduce billing surprise.

• Consider bundled payment alternatives: Value-based and episode-based billing (bundled payments) reduce fragmentation and can streamline revenue while aligning incentives for quality care.

Action Steps to Close Your Payment Gap

• Audit your accounts receivable to locate top “ungrouped” patient responsibility categories.

• Pilot a fintech financing solution with a subset of services or patient population.

• Train staff on transparent communication about pricing and financing options before service.

• Track metrics like collection rate, patient survey feedback, and net revenue post-adoption.

Final Thoughts

The gap between billing and bank balance sheet posting is an industry-wide pain but it doesn’t have to be a permanent drag. By partnering with fintech innovators, healthcare organizations can transition from chasing payments to receiving them upfront, while offering patients a simple, respectful, and flexible billing experience.

When providers aren’t stuck in debt collection, they can focus on what truly matters: delivering quality patient care. Adopting modern, transparent payment models is not just a revenue play it’s a patient-centric transformation.

Need help transforming your revenue cycle?

At Creare Solutions, we specialize in mental health and behavioral health billing including advanced fintech integration and modern revenue cycle strategies. We help providers streamline payments, reduce administrative burden, and increase patient satisfaction.

Let's schedule a consultation to help move your practice from billing to bank so you can focus on what matters most.