Patient Pay Revenue Rescue: Diagnosing Gaps in Post-Insurance Collections

Patient responsibility after insurance is one of the fastest-growing threats to practice revenue. Despite receiving care and insurance processing being complete, providers are still left chasing balances, and often come up empty. Some analyses show that hospitals collect just 47.8% of patient balances after insurance.¹ The longer the delay, the lower the recovery rate, especially for balances over $500.¹

raditional healthcare patient payment strategies aren’t built for this challenge. Statements go out late. Patients are confused. And internal billing teams are stretched thin. In this first post of our Patient Pay Revenue Rescue series, we explore why post-insurance collections drag and how to resolve breakdowns without compromising patient satisfaction.

Why Post-Insurance Collections Lag

When gaps in patient payment services exist, practices fall short of recovery goals. Recognizing and addressing these trends is the first step toward smarter, more effective collections.

1. Timing Is Everything — and It’s Off
   Most practices wait to start billing after an explanation of benefits (EOB). That means days or weeks go by with no communication, reducing urgency and increasing the chance of missed payments.
2. Patients Don’t Know What They Owe
   Patients might be unaware of or confused about the patient portion of the bill due to complicated statements. Pile this onto a delayed bill, and the motivation to make a payment diminishes.
3. Staff Bandwidth Can’t Keep Up
   Billing teams are expected to do it all: verify insurance, process claims, send statements, and field patient questions. Post-insurance follow-up often falls to the bottom of the list, not due to negligence, but capacity.
4. Technology Is Fragmented
   When statements, portals, emails, and texts don’t talk to each other, patients get disjointed, inconsistent communications. The result? Poor engagement, dropped follow-through, and a bad billing experience.

Strategies to Improve Post-Insurance Collections

Turning the tide on your healthcare patient payments process means rethinking the traditional approach to collecting patient payments after insurance. Here’s what successful practices are doing differently:

Start Patient Engagement Early. Communicate payment responsibility before the visit. A simple pre-visit reminder that includes billing expectations makes the post-insurance follow-up feel less like a surprise and more like a continuation of care.

Offer Payment Options. When patients face high deductibles, clear, upfront payment options make all the difference. PatientFocus provides flexible, predetermined plans that divide balances into manageable amounts and take the burden of plan management off your staff.

Use a Strategic, Omnichannel Approach. From mobile portals and QR-coded statements to click-to-pay texts, giving patients options helps reduce friction and increases satisfaction. PatientFocus combines omnichannel communication with a data-informed propensity-to-pay model to tailor outreach based on each patient’s behavior and preferences.

Support Your Staff with Expert Help. Outsourcing post-insurance communication to trained billing agents lightens the load on internal teams. Our domestic and bilingual Engagement Center handles over 50,000 calls each month, with 83% of them answered in under 30 seconds, and 79% resolved on the first try.

A Smarter Approach to Post-Insurance Collections

Uncollected patient balances cost the U.S. healthcare system billions, and a large share of that happens after insurance pays. But the solution isn’t just about more reminders or more staff. It’s about smarter timing, clearer communication, and tech-enabled engagement that make paying easier for patients and collecting easier for providers.

Want to take control of post-insurance collections now? Schedule a consultation and see how PatientFocus can transform your patient pay process.

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Sources

1. Taylor, M. (2024, February 29). Patient collections fall to 48%. Becker’s Hospital Review. https://www.beckershospitalreview.com/finance/patient-collections-fall-to-48/