Collecting unpaid patient balances: What top performers do differently

Collecting unpaid patient balances has always been tough, and with rising healthcare costs, high-deductible health plans, and changes in Medicaid coverage, today's medical practices are finding it harder than ever. In hospitals, 76% of patient balances remain unpaid, presenting a significant concern for private practices as well. The good news? When thinking about how to collect patient balances, there are effective ways to improve performance. This article highlights the strategies top-performing practices use to achieve better results.

Why collecting unpaid patient balances is so difficult

Collecting unpaid patient balances has been an evergreen problem in healthcare because there is no singular root cause. For example, patient balances may persist when patients:

• Don’t receive advance notice of what costs they will incur
• Don’t understand what they owe and why
• Face greater financial responsibility with higher deductible health plans
• Have limited financial resources and liquidity

Trouble collecting unpaid patient balances may also persist when practices:

• Default to inefficient and fragmented workflows
• Fail to provide convenient payment options
• Lack consistent approaches that balance regulatory requirements, operational risk, and patient experience
• Use manual, reactive collection processes

By addressing each of these challenges, practices lay a foundation for how to collect patient balances more effectively.

What makes the private practice setting so challenging

Collecting unpaid patient balances is often more challenging for practices rather than hospitals because practices typically operate with:

• Fewer resources
• Less sophisticated technology
• Limited financial counseling infrastructure

This means they have a harder time:

• Establishing consistent workflows
• Performing timely follow-up and responses to patients’ questions
• Setting expectations and collecting payments upfront

In addition, lower dollar amounts are more likely to accumulate in outpatient settings, creating greater barriers for collecting unpaid patient balances. Patients may not prioritize smaller balance accounts, incorrectly assuming their debt will simply be forgiven over time.

How to collect patient balances: Best practices for success

Top performers know that collecting unpaid patient balances isn’t a back-end task—it’s a front-end, experience-driven revenue strategy. When thinking about how to collect patient balances, these practices don’t chase payments—they design systems that make paying easy, expected, and almost automatic. This includes the following steps:

1. Set clear financial expectations. Provide patients with accurate estimates and train staff to conduct upfront conversations regarding how to collect patient balances.

2. Leverage simple and transparent bills. Remember: Clarity drives payment, and patients are more likely to pay when bills are easy to understand and align with estimates provided in advance.

3. Provide convenient payment options. Remove potential points of friction by permitting text, mobile, and one-click pay. Also provide flexible payment options that align with how patients manage their money (e.g., payment plans, digital wallets, and self-service options). Convenience is key when identifying strategies for how to collect patient balances more easily.

4. Perform timely outreach. Patients are more likely to pay when they receive personalized prompt bills shortly after services are rendered. Ensure timely statements and follow up as part of the plan for how to collect patient balances more efficiently.

5. Strive for a positive patient experience. Provide easy-to-access patient support via phone as well as HIPAA-compliant email, live chat, and SMS correspondence to each patient’s file. A positive patient financial experience builds trust and trust drives collections, both critical elements of success.

Addressing future patient collection challenges

Looking ahead, the biggest challenges for practices in collecting unpaid patient balances may center on:

• Growing financial pressure. As household budgets tighten, more patients will delay, fragment, or default on payments—putting pressure on cashflow and increasing the cost to collect.
• Inaccurate or delayed estimates. Without reliable, real-time estimates, practices will continue to struggle with trust, disputes, and delayed payments.
• Rising patient responsibility. A larger share of practice revenue will depend on patients who are less predictable than payers.
• The need to operate like a consumer payments business—without the infrastructure to support it. Patients expect healthcare billing to feel like retail or banking (text, mobile pay, instant answers). Practices that can’t meet this will fall behind.

Why empathic, tech-driven patient support is so critical

Successful practices are moving from reactive collections to proactive, technology-driven patient financial engagement, connecting with patients where they are financially and digitally. Using empathy makes patients feel heard, respected, and supported instead of pressured. This is crucial as more costs are passed on to patients who often face confusing bills during difficult times in their care journey. Practices that prioritize empathy by communicating clearly, offering flexible solutions, and providing responsive support help reduce barriers, increase confidence in billing, and make timely payments more likely. Learn how Inbox Health can help elevate the patient collections strategy using an empathic, patient-centered approach.

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