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SVC·02 · Patient Financial Services

The patient is now your third-largest payer. Treat them like one.

Transparent estimates before the visit. Dignified outreach after. Payment plans that actually get paid. NSA-compliant, 501(r)-compliant, bilingual, and brand-aligned to your organization. not ours.

Why this matters
Patient
responsibility
grew from ~10% to ~35% of revenue in a decade.
High-deductible plans, narrow networks, and price-transparency regs reshaped the back office. Most PFS programs haven’t caught up.
What we actually do

Six functions, in patient-time order. not call-center order.

PFS only works if it’s designed around the patient’s journey, not around our staffing model. Every workflow below is sequenced to the patient experience: pre-service first, point-of-service next, post-service last.

01

Pre-service price estimation

NSA-compliant good-faith estimates with line-item detail patients can actually understand. Modeled against the patient’s real benefits and remaining deductible. not a sticker price.

NSA-compliantReal-time benefitsDeductible-aware
  • Coverage: shoppable services, scheduled procedures, and inpatient stays. Generated within 1 business day.
  • Format: branded to your organization, in plain English (and Spanish where applicable). Auditable trail.
  • Outcome: estimate-to-actual variance reported monthly. the patient’s trust hinges on the gap, so we measure it.
02

Point-of-service collections

Scripted, measured, and reported weekly. Front-desk and pre-service teams are coached on the conversation, not handed a script and a quota. POS rate published in the monthly scorecard.

Scripted POSCoached, not policedWeekly POS rate
  • Tooling: integrated to your registration workflow. not a separate window the staff have to remember.
  • Coaching: monthly call review & role-play with your front-desk lead, not a vendor lecture.
  • POS lift: we publish baseline-to-current POS rate. Underperformance triggers script revision, not pressure.
03

Patient statements & e-billing

Mobile-first, branded to your organization. Statement copy is rewritten in plain English. we test for 8th-grade readability. Pay-anywhere: text-to-pay, web, IVR, mail, or portal.

Mobile-firstPlain EnglishText-to-payBilingual
  • Statement reads like a receipt, not a hospital bill. Each line item maps to a CPT and a plain-English service name.
  • Channels: text-to-pay, web portal, IVR, paper. Patients pick. you don’t pay for channels they don’t use.
  • Cycle: 3-statement cadence with progressive tone, then a phone touch. not a 5-statement assault.
04

Self-pay outreach & payment plans

Bilingual, dignity-first scripts. We talk to people, not accounts. Plans are right-sized to disposable income, not to a default 6-month grid. The plans we set up actually get paid.

Bilingual ES/ENDignity-first scriptsIncome-aware plans
  • Talk-off philosophy: we never threaten credit. We explain options. Patients respond. and pay. better.
  • Plan sizing: monthly amount is set against household budget, not a default schedule. Default rates are lower.
  • Bilingual: native Spanish-speaking agents, not interpreters. Caribbean and Mexican dialects represented.
05

Charity care & financial assistance

501(r)-compliant workflow that actually finds eligible patients before they go to bad debt. Documented sliding-fee. Approved-charity reporting that satisfies your audit committee.

501(r) compliantPre-bad-debt screeningAudit-ready
  • Pre-screen: every uninsured / underinsured patient is screened against your FAP before a statement cycle starts.
  • Application support: bilingual case managers walk the patient through the application; nothing falls into a void.
  • Reporting: charity-care expense and FAP-eligible bad-debt reconciled to your IRS Form 990 schedule H.
06

Bad debt & pre-collection

Recovery without reputational damage. Patients who’ve been worked through our PFS lane and still don’t pay are the only ones referred. and only to vetted, ethical agencies on a published roster.

Pre-collection laneVetted partners onlyReputation-aware
  • Bad-debt threshold: only after a full PFS cycle (statements + payment-plan offer + charity screen).
  • Agency vetting: published roster of compliant agencies. We monitor complaint rates monthly.
  • No surprise referrals: patients are notified by mail and phone before placement, in writing. Disputes pause placement.
The patient journey

Five touchpoints. Each one designed, not improvised.

PFS quality is decided in the moments most programs treat as throwaways. the estimate, the first statement, the bilingual phone call. We’ve designed each one.

PRE-SERVICE
The estimate conversation

Good-faith estimate generated and walked through with the patient before the appointment. Variance written down.

DAY OF SERVICE
POS collection

Front-desk staff use scripts coached against the patient’s actual benefits. Co-pay, deductible, plan share. clear.

DAY 14
First statement

Mobile-first, plain English, in the patient’s preferred language. Pay-anywhere link. Charity-care path visible.

DAY 30-45
Outreach call

Bilingual agent, dignity-first script. Plan offered, sized to budget. Charity-care application started if eligible.

DAY 75+
Pre-collection review

Senior PFS lead reviews unresolved accounts before any external referral. Reputation gets a human last look.

What we measure

Five outcomes. Reported monthly.

Activity metrics (calls dialed, statements sent) are easy to game. We measure outcomes. the patient’s experience, your collected dollars, and your reputation.

METRIC TYPICAL TARGET WHY IT MATTERS
Estimate-to-actual variance < 8% If the estimate is wrong, trust is gone. We measure how often the patient pays what we said they would.
POS collection rate +15-25% Lift over pre-engagement baseline. Cash collected at the front desk is cash you don’t chase later.
Self-pay collection yield +20-30% Lift on the self-pay book. Better scripts + right-sized plans + bilingual coverage = more paid plans.
Patient complaint rate < 0.5/1000 Complaints per 1,000 statements. Tracked weekly, shared with your patient-experience team.
Bad-debt placement rate −30-40% Reduction in accounts referred to external collections. Lower placement = lower reputational risk.
Compliance posture

NSA, 501(r), HIPAA, FDCPA. Built into the workflow.

Compliance isn’t a quarterly attestation. It’s the design of the workflow itself.

REGULATORY
No Surprises Act

Good-faith estimates, balance-bill protections, IDR readiness. Built into every estimate & statement workflow.

REGULATORY
501(r) & charity care

FAP-eligible patients screened pre-statement. Application support is bilingual. Reconciled to Schedule H.

REGULATORY
HIPAA & HITECH

SOC 2 Type II audited, BAA-backed, role-based PHI access. Every patient touch logged and audit-ready.

REGULATORY
FDCPA & state collection law

Pre-collection lane is FDCPA-aware before any external referral. Vetted-only agency roster, monitored monthly.

REGULATORY
Price transparency

CMS HPT and shoppable-service compliance. Public-facing tools branded to your organization, not ours.

REGULATORY
Language access

Section 1557 / Title VI. Bilingual native agents (ES/EN), with telephonic interpretation for 200+ languages.

THE STRUCTURAL CHOICE

Patient-financial done in your brand voice, not ours.

Our agents answer the phone with your organization’s name. Statements carry your logo, your colors, your patient-services line. Patients never know they’re talking to a vendor. they shouldn’t have to. Your reputation is the asset; we’re the machinery behind it.

WHAT THAT MEANS IN PRACTICE

White-label all the way down.

  • Branded statements. logo, color, tone, and patient-services line all yours.
  • Branded phone presence. agents introduce themselves with your organization name.
  • Branded portal & estimates. payment portal, estimate UI, e-bill all in your visual system.
  • Coached on your tone. we listen to your patient-experience team’s style guide and train to it.
  • No vendor mention. we never sell, upsell, or insert ourselves into the patient relationship.
PFS scorecard

Four outcomes. Reviewed every month.

POS lift
Vs. pre-engagement baseline
Front-desk cash up, back-end chasing down
Self-pay yield
Net collected on the self-pay book
Better scripts, right-sized plans
Complaint rate
Per 1,000 statements
Reputation, measured
Bad-debt placement
Down vs. baseline
Lower referrals, lower risk

Mystery-shop your own statement.

Send us last month’s patient statement and we’ll send back a 4-page critique. readability, channel mix, charity-care visibility, complaint risk. No obligation.