Patient Financial Services: How Patient Pay Becomes Patient Debt

By Infinx
November 15, 2018

With all the recent healthcare reform changes, the cost of health insurance increasing and higher deductibles, patients are forced to pay more out-of-pocket and it is adversely affecting revenue for many hospitals and medical practices. In this blog, we review patient debt origins and examine how it is affecting physician revenue and practice stability, and how you can prevent loss of revenue in your practice.

30% of your revenue can walk out the door every day. Why let it? Patient pay now accounts for up to 30% of account receivables for physician practices, with receivables growing faster than patient revenue. If you don’t collect patient self-pay at the time of visit, your chances of collecting it dwindle rapidly the moment your patient walks out the door. In fact, 90% of patients are likely to pay before they see their physician, 70% are likely to pay at checkout, 40% are likely to pay after they leave the medical practice, and 11% never pay.

Patient Medical Debt and High Deductibles

Patients are carrying higher levels of medical debt due to high deductibles, which makes it harder for them to pay their bills. Together these factors can easily endanger physician practice and hospital revenue. The only protection against that is the implementation of proper systems to identify, verify and collect patient payments at the time of visit.

Medical debt can make it difficult for providers to collect the amounts due, especially from patients with health insurance plans with high deductibles. In fact, patients comprise 95% of the bad debt carried by physicians, which includes uncollected amounts from Medicare and Medicaid patients.

    • Orthopedic surgeons carried 8.7%
    • OB/GYNs: 6.7%
    • Cardiologists: 6.6%
    • Primary care: 5.2%
    • Pediatricians: 4.2%

Those may seem like small percentages, but if you are an average hospital-owned physician practice generating approximately $1.5 million, can you afford to lose $50,000 of that to uncollected revenue?

Providers Must Address Patient Pay Services

None of this bodes well for providers. When patient pay isn’t collected at the time of visit, it is more likely to turn into bad debt. The solution is to implement rock-solid revenue cycle management practices that address patient pay. It starts with patient financial services that incorporate rapid insurance verification and patient pay estimation. That creates a transparent approach that can engage patients in a payment plan at the time of visit, increasing the likelihood that they will pay.

Automate 100% of Your Insurance Patient Pay Estimations

Capturing revenue in the payment lifecycle begins with insurance coverage and eligibility. When your patient walks in for care, you need immediate information on coverage, insurance type, network, coinsurance, deductible remaining, out-of-pocket maximums, and more. High deductible insurance plans aren’t going away anytime soon, and the bad debt they create for physicians is an untenable situation so addressing patient pay at the first point of contact between practice and patient is the only place where an effective solution can take place.

The Infinx Patient Access Software is a patient access workflow solution that will automate 100% of your insurance patient pay estimations. It helps you get ahead of the revenue cycle problem by quickly authorizing and confirming every procedure rendered. The insurance verification and eligibility module is part of our software solution. With seamless HL7 integration to your EHR system, and a vast network of clearinghouse integrations, our software provides real-time insurance coverage data for your most important coverage concerns. If information is not available, the Infinx team is ready for immediate follow-up.

Real-time results increase payment velocity and moves you from coverage unknowns to insurance verification in seconds. You have actionable information and the details necessary to arrange payment schedules with patients. A knowledgeable patient is a happier patient; and a reimbursed practice is a more profitable one.

Let Infinx help you preserve more revenue. Request a demo to learn more about our insurance eligibility and verification software. Contact us at

About the Author



Infinx provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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