Published: Jan 31, 2024
Revenue Cycle Management

Self-Service Patient Payments: How to Use Them to Improve Patient Satisfaction & Revenue

Suzanne Delzio
Suzanne Delzio
8 minute read
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Remember when your dad or grandma refused to buy products on because they didn’t trust online credit card payments? Today, we walk up to older relatives’ doorsteps to find those familiar Amazon boxes waiting. 

Healthcare consumers are also embracing the convenience of online, self-service patient payments. And in a big way.

A snapshot by the numbers: 

437% - rise in patients paying medical bills via online bank bill pay portals from 2019 -2022 (75% increase yearly increase.) The same study finds just 9 percent of patients want to pay medical bills using a paper check.

91% -  portion of respondents in the above study who say they prefer electronic payment methods

71% - of consumers in an Instamed survey who prefer to pay their bills online. 7% of consumers prefer to pay via check in the same study. 

62% - of consumers in a recent Salucro survey of 1,348 U.S. healthcare consumers who say patient portals were their favorite method for paying medical bills. 

With more patients eager to use online bill pay, healthcare organizations can capture maximum net revenue using self-service patient payments pre-service, and also throughout the patient journey, and during back-end billing. Here you can review the best ways to offer self-service patient payment options to patients and improve revenue. 

What are self-service patient payments?

Self-service patient payments in healthcare are digital and automated platforms that allow patients to handle their medical bills at their convenience. These systems empower patients to view bills, access payment plans, understand their insurance benefits, and make payments online without the need for direct interaction with billing staff. By integrating seamlessly with healthcare providers' billing and even practice management systems, self-service payment platforms offer a transparent, user-friendly, and efficient method for patients to fulfill their financial responsibilities. This approach not only enhances the patient financial experience by providing clarity and control over healthcare expenses but also improves the efficiency of healthcare providers' revenue cycle management.

One critical difference between traditional payment systems (physical bills and statements and in-person, front desk collection) and self-service patient payments is who initiates the process. Providers initiate traditional payments by requesting them at the front desk (unpopular with staff, physicians, and patients) or by mailing statements. With self-service, patients may receive notification that their bill is ready, but they control how and when they pay. 

Self-service patient payments depend on good faith and patient payment estimates. Take a quick tour of how you can automate eligibility verification and estimate generation here:

Self-service patient payments landscape in healthcare today

Despite the advantages self-service patient payments offer, healthcare has some catching up to do. Paying in person at the doctor’s office or by mail is still the primary way consumers of all generations handle medical bills today. Most physician practices and groups still bill after service, expecting checks in the mail or electronic payments transacted via e-statements. 

Missing the surging preference for online bill pay robs healthcare leaders of significant opportunities. Vice President of RCM Valerie DeCaro of DOCS Dermatology, explains that contrary to common belief, staffing is not the biggest impediment to revenue cycle improvements. Instead, she explains,

“One of the biggest problems in the revenue cycle today for MSOs is the lack of catch-up in healthcare around using automation and technology. We have many archaic workflows, and we still use fax machines regularly. Some practices still operate on paper systems. We're not anywhere close to where other industries are. Take air travel. You can check in at an airline on your phone, get text reminders, pay for your bag, print your tag, do all of that before you even get to the airport.”

DeCaro advocates for healthcare to strive for the same level of simplicity and ease for the consumer.

Advantages of offering self-service patient payment options for providers

Increased payment collection

When patients direct their own payments, their sense of responsibility for their care increases, a phenomenon that translates into increased net revenue for providers. Juli Smith, Director at ZOLL Data Systems explains,

“Partnering with the patient on the financial responsibility early in the process increases the odds of collecting maximum self-pay dollars.” 

Then, too, when providers offer self-service options for upfront, pre-service payments, they bring in more revenue. The time for providers to insist on having patients pay at least a deposit upfront just like accountants and mechanics do has arrived. 


Today, patient payments now account for 30 percent of provider revenue. Before the Affordable Care Act, patients were only obligated to pay about 10 percent of the healthcare organization’s bill. But high-deductible healthcare plans have pushed more of the financial responsibility onto patients. That means providers must be more aggressive in getting payments from patients. Further, given that the chances of patients paying in full decrease once the patient leaves the clinic, getting those upfront payments helps ensure you get more revenue. Every dollar collected upfront stays out of accounts receivable after all. 

The potential for improved revenue is illustrated in a case study involving Texas’s Abilene Diagnostic Clinic, a multispecialty physician group with 50 providers across 14 specialties, serving 19 Texas counties. This organization faced challenges with disjointed billing and collection processes, leading to confusion among patients receiving multiple bills. Once the organization implemented a more consolidated billing process that included a self-service patient portal, more patients began making payments, including those with accounts 90 days past due. They enjoyed a 21% increase in patient payments in just six months. Days in A/R dropped from 32 to 25 days, improving cash flow. In addition, costs declined. ADC saw a 36% decrease in statement costs in the first six months of the new system. 

In another example, Tenet Healthcare Corporation (53 acute care hospitals in 12 states, earning $9 billion in revenues annually) struggled with increased expenses and patient wait times due to the transcribing, keying in data, printing, filing and disposal involved with paper-based registration forms. The organization was also looking for ways to improve accuracy in the patient access and billing processes. Errors were causing denials, and we all know that denials (at an average of 12% in the United States) can decimate revenues.  

 Ron Kelley, Tenet's Senior Director of Revenue Cycle Services, explains,

 “The problem with allowing inaccurate patient information to survive the registration process is it tends to lead to claim denials and re-work that the billing office will have to handle later.”

After setting up a portal, Tenet’s patients not only began to use online bill payment to pay upfront, but they also view account status, update profiles and pay outstanding balances securely. Better, patients set up recurring payment plans, find a glossary of billing terms, and access frequently-asked billing questions. This convenience for patients also improved Tenet’s cash flow, as they immediately began receiving between $600,000 and $825,000 in online payments per month.

Improved patient outcomes

Patient ownership of their healthcare leads to patients making healthier choices, which in turn create better overall outcomes. 

A thorough screen of 3456 records conducted by the Journal of Internet Medical Research concludes that, due to the sense of empowerment that comes with the ability to track their healthcare, patient portals often enhance the doctor-patient relationship, improve health status awareness, and increase adherence to treatment protocols. 

Experian’s 2023 State of Patient Access Survey confirms these advantages. It found that adherence to care plans is far more likely when patients are engaged in the positive, streamlined and user-friendly pathways that self-service patient portals and payments offer. When patients feel positive about their healthcare experience, their loyalty improves and they are more likely to refer an organization. 

Improved patient satisfaction

A self-service, digital approach aligns with the high-tech preferences of younger consumers. Millennials (the largest age cohort in the US) and Gen Z are accustomed to paying for travel, products, and even services online. Research shows they are seeking the same convenience and flexibility in their healthcare financial experiences. This trend will only increase. A survey of 1,500 consumers by Adobe Digital Insights indicates that about half of people under 35 prefer to interact with a computer than a human. 

Reduction of Administrative Burdens

Self-service payment options help healthcare organizations address staffing challenges by reducing manual workloads and administrative tasks associated with billing and payment collection. Automation enables healthcare providers to allocate resources more effectively, enhancing overall productivity and patient care quality. 

The forms of self-service payment platforms

Patient portals

Many patient portal providers, including ATouchAway, Klara, and HealthCloud, offer integrated self-service patient payment options. This integration allows healthcare providers, including physician groups, to offer self-service patient payment experiences within the same portal used for medical records and appointment scheduling. While some might require collaboration with external payment processors or financial services, vendors do all they can to deliver a comprehensive platform that includes both medical and payment functionalities, eliminating the need for a separate vendor for patient payments.

The InstaMed Consumer Portal, for example, allows patients to enroll in auto payments and create payment plans. This feature enables patients to manage their payments over time, catering to their financial planning needs. It also stores payment methods and insurance information, further facilitating a seamless self-service experience.

In-office kiosks

Self-service patient kiosks inside healthcare organizations don’t provide the comfort of paying from home but they do allow patients to manage their payments at their own pace without the possible discomfort of dealing with an agent. By using automated tablet or desktop systems that connect to the patient portal, healthcare facilities can reduce the workload on staff. Patients can take their time reviewing billing information at the kiosk, so they can understand their charges and payments without the pressure of having to respond to the agent.

You’ll find self-service payment kiosks in hospital outpatient departments, medical clinics, specialty care centers, dental offices, and pharmacies. As technology continues to evolve, we can expect to see further integration of such solutions across the healthcare sector, driving improvements in both operational efficiency and patient care.

Pre-service estimates

Most healthcare organizations are not yet on board with giving patients an itemized list of costs ahead of time. Research shows that doing so, however, improves provider collections. 

Of course, the 2022 No Surprises Act mandated that all providers must provide non-insured and self-pay patients with a patient payment or “good faith” estimate at least three days before their scheduled appointment. Some healthcare organizations even adopt this practice for their insured patients. Florida four-hospital healthcare system Health First resolved to adopt a “100 percent estimate, 100 percent ask” protocol that included insured patients. With the help of an outside estimate vendor, every one of their patients received a cost estimate for their care. This shift increased upfront collections by 27 percent, helping the system reach 2.7 percent of net revenue in point-of-service collections. Given that the industry benchmark is 0.7 percent, the new system exceeded organizational expectations. Similarly, California-based clinical lab testing company Counsyl increased revenue collected from patients by 63 percent after adopting a patient cost estimation tool.  

A pre-service estimate can include links to a patient portal where all costs, payment methods, and payment plan options are listed. Of course, they're more willing to pay upfront because they know exactly what services and products they're paying for.


E-statements typically exist as a bill sent as email, but when they contain a link to a patient portal, they, too, land in the self-service category. 

InstaMed and other patient portal vendors encourage healthcare organizations to spend time explaining how to use e-statements and patient portals.

Integrating eStatements with online payment portals and enhancing patient communication and engagement strategies aligns with the digital transformation trends in healthcare. It also addresses the preferences and expectations of modern consumers, leading to improved patient satisfaction and potentially faster payment collections.

Where self-service payments fit into the patient journey

A competent patient estimate solution company knows well that the healthcare organization must carefully usher the patient through the financial side of care. That means clear direction from the point of registration through the close of the account. 

Provide opportunities for patients to access self-service payment portals at various points in their care journey. 

Pre-Service and Point-of-Service Payments

While, as mentioned above, pre-service or “good faith estimates” are mandated only for self-pay and uninsured patients, more insured patients are asking providers for them and more are providing them. 

Upon patient registration and scheduling, some healthcare organizations are choosing to send out pre-service patient payment estimates. A competent solution automates eligibility verifications, generates accurate patient estimates, and sends a text or email to the patient delineating their financial responsibility. A thorough estimate includes a clear breakdown of deductibles, copays, and coinsurance. These communications increase the patient’s confidence in using your services. The estimate can include an embedded link to your existing payment portal or SmartPay platform so patients can easily send in a deposit or prepay the entire estimated bill. 

The less confusion surrounding the payment experience, the more satisfied your patients will be and the more likely they will be to pay on time and in full.

A January 2022 PYMNTS report reveals that, when patients know their bill beforehand, 89 percent characterize paying as “easy.” Despite this positive response, the same study shows that only 30% received an estimate beforehand. 

Mid-journey and Post-Care Payments and Billing Management

Once care has been delivered, patients frequently use self-service portals to manage and pay their bills. From front-end to back-end, automating various processes enables more accurate billing, reduces denials, and facilitates easier patient payments, pointing towards a more integrated approach to RCM. 

The success of these tools hinges on their ability to provide transparent, customizable, and user-friendly interfaces that align with the consumer-like expectations of patients today.

Patients sometimes need staff member assistance

While the adoption of self-service patient payment solutions offers numerous benefits, healthcare providers must navigate the area’s challenges such as ensuring data security, maintaining regulatory compliance, and addressing the digital divide among patients. Providing education and support to patients unfamiliar with digital payment methods is crucial to maximizing the adoption and effectiveness of these platforms.

Using self-service portals can challenge seniors in particular, as was revealed in this case study. 

One 600+ bed health center with 26 locations in 25 Southwest counties decided to accept all payments via online bill pay. This move did not increase patient satisfaction across the board. Instead, 45 percent of patients responded favorably to using a digital portal, while 55 percent wanted and needed a live person to help them understand the costs listed in their bill and the options they had to pay it. 

Before you unleash self-service patient payments, examine your patient population to determine whether they’re ready to go fully digital. 

Healthcare consumer attitudes are changing fast

Give your patients the pricing transparency and ease of payment they crave

Rapid shifts in consumer perspectives on healthcare payments, combined with ongoing financial challenges for providers, mean staying current with self-service patient payments is critical now. 

Sophisticated, patient-focused payment options adapt to this fast-changing financial environment in healthcare. MD Clarity's Clarity Flow offers precise and easy-to-understand cost estimates for patients, enabling them to pay in advance and boosting your early collections. Such interactions build trust among patients in your services, helping them to make well-informed payment decisions. Whether it's improving patient payments or analyzing payer contract efficiency, discover your prime chances for reclaiming revenue. Request a demo to learn how MD Clarity can help recover lost revenue for provider groups and management service organizations.

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