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A comparative look at simplified and itemized patient statements.


A teenager just became a multimillionaire by selling an app he created that summarizes content found on the Internet. Yahoo reportedly paid $30 million in cash for Nick D’Aloiso’s smartphone app, Summly, indicating the growing demand for concise, trimmed information by those who consume web content. Apparently, we live in a “get-to-the-point” world.

Yet, in contrast, we’re also inundated by the call for transparency. Now more than ever, people want full disclosure so they can access all the layers and details of corporate activity and transactions. The same consumers who demand streamlined, nut-shelled content also want access to details and comprehensive inner-workings.

The seemingly disparate demand for both summarization and full disclosure is familiar to those of us in the business of health care. For a long time, we’ve been grappling with whether to summarize or itemize patient billing information on statements. In our quest to make our processes and communications friendly to patients, we’ve considered different approaches for conveying costs, payment terms, and requirements to patients who express the desire for simplicity and transparency.

Out in the market, we see a range of tactics currently being employed. Some providers have erred on the side of brevity, offering simplified statements that spotlight only the key totals that patients need to know in order to pay. Other providers have maintained the more common itemized approach.

What works best? Though we don’t have a formal study to tell us quantitatively, we can look at each approach to identify merits and challenges.

Simplified Statements

The goal of any statement is to effectively communicate payment responsibility to evoke appropriate, prompt response from the party who must pay. Simplified or summarized, statements can be very effective in clearly stating what’s owed and when it’s due without cluttering statements with extreme detail that can complicate messaging.

Thanks to the flexibility of digital printing, providers can now customize and print statements on demand, in small quantities, in color, with call-outs, and with highly targeted messaging to get points across. Versatile design elements work well with simplified statement formats. As a side benefit, summarized statements require less paper, which helps to reduce overall printing and mailing costs and keeps the physical mailer more manageable for the recipient, who has fewer pages to shuffle.

However, fully summarized statements exclude details that some patients may find helpful in understanding and assessing total payment due. The simplification may, in fact, be too simple in some cases, leading patients to call customer service for additional information or to request itemized documentation.

Providers should include key information on summarized statements to compel payment response from patients, while limiting demands on customer service departments.

Itemized Statements

Statements that list all charge details help providers maintain transparency with patients. These statements are the billing equivalent of full disclosure, an approach that keeps providers accountable and patients informed. The thoroughness of information puts everything at the patients’ fingertips and provides quickly accessed records of encounters. 

Ironically, detailed statements are often reported to spark more questions than answers, as patients may become confused in reviewing the line items. If itemization is employed, it’s essential that the statement is designed so that key pieces of information, such as total due and payment deadline, are clearly marked and can be quickly identified by the patient.  

A Combined Approach

Many providers incorporate summaries and itemization in their patient statements to cover all the bases. The most effective statements that take this “dual track” provide a summarized cover page that is well designed to call out amount due and payment due dates, with subsequent pages offering itemized details for further reference. These statements use color, text blocks, and call-outs to punctuate the most pertinent, actionable information up front yet include the full scoop in case patients care to review the details. 

In Summary, Summarize (Even if You Itemize)

Take a cue from the aforementioned Summly app that creates web content “cliff notes”: prioritize the need to summarize key information for patients. Certainly, the inclusion of itemization can hold great merit and support your commitment to being a transparent organization for patients. However, you can’t ignore the benefits of making your statements’ front page the ultimate tool for inspiring payment response. Considering that a majority of patients simply want to know what they owe and when it’s due, your organization will be well served to make those answers known up front.


Emdeon ExpressBill Services streamlines your billing processes while also streamlining your statement content and design.

Publication Date: Wednesday, May 15, 2013