02 — Capability · BC-1840.50
Patient Billing & Collections
Bill patients clearly for what they owe after insurance, offer realistic ways to pay and collect fairly, within the organization's financial assistance policy and consumer protection rules. Collections for non-patient customers sit with billing and revenue.
- Self-Pay Billing
- Patient Collections
- Patient Balance Resolution
In scope
- Patient statements and digital billing
- Payment plans and online payment
- Patient billing inquiries and disputes
- Self-pay follow-up, bad debt and collection agency placement
Out of scope
- Collections for non-patient customers (see BC-250.30)
- Financial assistance screening and estimates before care (see BC-1810.50)
- General customer service contacts (see BC-450.20)
Realized by · 3
- Epic · Revenue Cyclecore via BC-1840.50.10
- Oracle Health · Oracle Health Paymentpartial via BC-1840.50.20
- MEDITECH Expanse · Revenue Cyclecore via BC-1840.50.10
Used in · 1
Build it · 1
Decomposes into · 5
- BC-1840.50.10Patient StatementsSend patients clear statements of what insurance paid and what they owe, on paper or digitally, consolidated across visits where possible.
- BC-1840.50.20Patient Payment PlansOffer patients installment plans and online payment options that fit their means, and keep each plan on track.
- BC-1840.50.30Patient Billing InquiriesAnswer patients' questions and disputes about their bills, correct errors and explain what insurance did, with each inquiry tracked.
- BC-1840.50.40Self-Pay Follow-UpFollow up on unpaid patient balances on a fair, documented schedule, checking for financial assistance before any escalation.
- BC-1840.50.50Bad Debt & Agency PlacementWrite off balances that cannot be collected, place them with collection agencies under the policy's limits on extraordinary collection actions, and reconcile agency recoveries.