Purpose
1. Automate copay and outstanding balance collection reminders to patients via SMS/email.
2. Automate the reduction of manual follow-up for payment, minimizing overdue accounts and staff effort.
3. Automator retrieves overdue balances, outstanding co-pays, and patient contact details.
4. Automation ensures reminders are compliant with HIPAA regulations using secure communication.
5. Schedule automation for reminders at specific milestones (e.g., immediate, 7 days, 30 days overdue).
6. Automated logging of communication for audit and compliance tracking.
Trigger Conditions
1. Balance or copay marked as due or overdue in the clinic’s billing system.
2. New patient invoice or billing statement generated with outstanding amount.
3. Non-payment status persists after scheduled interval (e.g., 3/7/14 days post-visit).
4. Change in payment status in EMR/EHR systems or payment portals.
5. Scheduled recurring automation based on each patient’s account aging report.
Platform Variants (sample configuration per automatable channel/service):
1. Twilio SMS
• Feature/Setting: Use ‘Messages’ API to automate outbound SMS; set ‘body’, ‘to’, ‘from’, and webhook for delivery status.
2. SendGrid Email
• Feature/Setting: Use ‘Mail Send API’; automate dynamic templates with fields for patient, balance, and link to payment portal.
3. AWS SNS
• Feature/Setting: Publish SMS/email notifications; template message including dynamic insertion for patient/amount.
4. Nexmo (Vonage)
• Feature/Setting: Use ‘SMS API’ for triggered messages; automate webhook to track responses and delivery callbacks.
5. Mailgun
• Feature/Setting: Automate outgoing billing emails via ‘Messages API’ with PDF invoice links.
6. Plivo
• Feature/Setting: Automates bulk SMS via ‘Send Message’ endpoint and status callback for confirmation.
7. WhatsApp Business API
• Feature/Setting: Automate template messages for copay follow-up using WhatsApp Cloud API.
8. Stripe
• Feature/Setting: Payment Link API to automate embedded links in reminder messages; Webhook for payment detection.
9. Slack
• Feature/Setting: ‘Chat.postMessage’ API to automate staff notification channels on overdue accounts.
10. Zapier
• Feature/Setting: Automate triggers from EHR/billing to SMS/email by linking connected apps (e.g., Gmail, SMS, EMR).
11. Salesforce Health Cloud
• Feature/Setting: Automate outbound messaging via Health Cloud Flow, triggered by billing status change.
12. HubSpot
• Feature/Setting: Automate sequences for unpaid invoices using Contact workflows.
13. Google Workspace (Gmail, Calendar)
• Feature/Setting: Automate personalized email reminders and log events for follow-ups.
14. Microsoft Outlook/Office 365
• Feature/Setting: Automate scheduled emails via Microsoft Power Automate, pulling data from billing status update.
15. ClickSend
• Feature/Setting: Automate SMS/email reminders for balance collection using ‘Send SMS’ and ‘Send Email’ APIs.
16. RingCentral
• Feature/Setting: Automates SMS/email notifications from their unified messaging platform; webhook automation for reply capture.
17. ActiveCampaign
• Feature/Setting: Automate dynamic engagement sequences with reminders and payment call-to-action.
18. Intercom
• Feature/Setting: Automated messages via user profile triggers based on billing data import.
19. Pipedrive
• Feature/Setting: Automate deal-based reminders using workflow automation for overdue balances.
20. Freshdesk
• Feature/Setting: Automate ticket generation and reminder email/SMS when payment remains unresolved.
21. QuickBooks Online
• Feature/Setting: Automated overdue invoice notice via QuickBooks automated reminders, integrated with messaging APIs.
22. DocuSign SMS Delivery
• Feature/Setting: Automate copay authorizations via SMS delivery with embedded secure payment authorizations.
Benefits
1. Automates copay and outstanding payment collection, streamlining revenue cycle management.
2. Reduces no-payment instances and automates follow-up activity.
3. Automation minimizes manual labor, saving staff hours and costs.
4. Automated reminders increase collections rates and DSO (days sales outstanding).
5. Ensures timely, consistent, compliant collections processes via fully automatable reminders.
6. Allows scale-up of patient account follow-ups without additional administrative load.
Billing & Insurance Workflows