The cornerstones of effective patient billing are clarity of information and ease of response.


For patients to be ready and willing to make payments, they must understand what’s owed, why it’s owed, when it’s due, and they must be able to easily take action to settle their accounts. A patient who receives a mailed bill and has questions or perhaps can’t find a stamp to place on the return envelope has the potential to become a slow- or no-pay customer.

Enter the electronic patient statement. 

What Is an Electronic Statement?

Electronic statements or e-statements are the modern take on traditional, mailed statements. Delivered digitally—typically via email—electronic statements circumvent physical mailboxes and land in the virtual inboxes of today’s constantly connected consumers. They serve as cost-effective, immediate touch points with patients who are adopting electronic payment and account management processes at a fast pace across the board.

E-statements are interactive portable document files or iPDFs that are best used as part of a total electronic patient financial communications solution. iPDFs stand in place of traditional, mailed bills and function like customized user interfaces that open in default web browsers of the computing devices on which they are activated. They must be accessed through security layers to ensure protection of sensitive healthcare information (The Future of Edelivery, Emdeon, 2013).  

As this mode of financial communications hits its stride, it’s important to start with an intentional design; electronic statements are received and viewed differently, so they should be designed differently. 

Here are tips to help providers achieve even more clarity of information and make it easier for patients to pay.

Design for Interactivity

Do not simply convert existing, traditional statements to PDF format when creating electronic statements. Use every design element to encourage interaction and evoke response. Infuse personalized messaging and clickable calls to action, as well as branding for the organization. 

Include response triggers. Use buttons, live links, mouseover text, and hyperlinked graphics to inspire clicks. Email marketing professionals report that the use of buttons can result in more clicks, so placing a “pay now” button prominently on statements has potential to measurably improve results.

Prioritize personalization. Providers can target information to recipients in easy-to-customize electronic statements. From specific wellness messaging to custom reminders, providers have the chance to make financial communications more meaningful. These elements can link to more information online to keep patients engaged. There’s a variety of personalized features that can be included in e-statements.

  • Estimates/patient responsibility calculations for scheduled procedures/services
  • Appointment reminders/directions
  • Pre-appointment paperwork (bring with them to the appointment)
  • Discharge instructions
  • Hospital policy documents such as Patient Rights and Responsibilities and HIPAA notification
  • Consent forms for signature
  • Advanced directives (Advance Care Plan)
  • Pre-procedure instructions (e.g., diet, time to arrive, etc.)
  • Valuables/property record documentation
  • Preventative care and wellness messaging
  • Information and sign-ups for events/seminars

Invite two-way communications. Include contact forms and live email links to make statements an open door to two-way communications. As providers try to reduce billing-related call volumes, electronic inquiries can be helpful in filtering questions and responding in more manageable ways, while also giving patients the power to submit questions at their convenience. 

Design for Clarity and Transparency

A recent focus group study conducted revealed that patients want statements that offer clear summaries of their billing upfront, supported by detail pages (“Effective Patient Statements” White Paper, Emdeon, 2013). When providers present both elements upfront, patients perceive costs to be more transparent and understandable. This can lead to reduction in the volume of inbound calls for clarification that can burden customer staffs and inspire more trust between patients and providers. 

Start e-statements with a summary page that makes it simple to identify what’s owed and when it’s due. By using a good layout with color and call-outs, as well as mouseover/hover text, providers can guide recipients’ experiences with their statements. Use of intentional design will help patients visually take notice of key pieces of information at a glance. Include interactive buttons that click through to an online payment portal. Communication is visual, so the look and layout are vital to how information is conveyed.

Continue the clear lay-out through to detail pages, as well. Be consistent in the chronological presentation of charges. Use font sizes that are readable for people of all ages. If not using color on subsequent pages, incorporate bold, underlined, and italicized text to draw attention to certain information. There’s no limit to the interactive functionality that can be present on detail pages, so consider including “pay now” button throughout for convenience.

Design for Mobility

Forty-seven percent of email is viewed on mobile devices today, so bear this in mind when creating both email messages and associated web pages (Study of 250 Million Email Opens, Litmus, 2013). It’s best to employ responsive design so that layouts automatically detect the type of device on which they’re being viewed and fluidly configure to fit the appropriate screens. 

Mobile-friendly design is grounded in functionality more than aesthetics. Messaging optimized for mobile access will typically be a simpler design of the desktop version, incorporating easy-tap buttons and hierarchal arrangement of content that works with or without images and graphics. The easy-tap buttons can be key to making immediate payments from mobile devices possible. It’s essential that click-throughs from e-statements lead to payment portals that are easy to navigate on mobile devices in order to garner the best boost in collections.

Design for Authenticity

Respondents in the previously mentioned focus group study were clear about design elements that didn’t work: For example, patients didn’t care for stock photos of smiling medical professionals (Effective Patient Statements, Emdeon, 2013). They resoundingly stated that inclusion of such design elements was as unappealing as it was unnecessary. In contrast, the participants voiced positive perspectives regarding use of color and call-outs to help navigate their bills to find key information.

There’s no denying that the future of health care is being driven by electronic initiatives and increased consumerism. E-statements hit on all marks, serving as a cost-effective, nimble mode of patient financial communications, and providing today’s patients/consumers quick access to the payment management tools they expect. Providers who take the lead with e-statements are poised to enjoy improved collections—by design.

Emdeon is a provider of revenue and payment cycle management and clinical information exchange solutions that connect payers, providers, and patients in the U.S. healthcare system.

Publication Date: Monday, March 17, 2014