Patients don’t understand their medical bills: How billing teams can help

August 19, 2022

5 minute read

woman viewing e-statement

The dreaded medical bill. Many patients feel a sense of anxiety before they even open the envelope, email, or text message. In an era of high-deductible health plans, patients are asking themselves,  “How much will I owe? Will I be able to afford to pay the balance? Am I facing significant medical debt?” 


For some, the anticipation of their financial obligation is too difficult to bear. They may simply discard the message without even looking at it. If they do take a peek, there is no guarantee they will follow through with payment in a timely manner or at all. The end result: Cashflow bottlenecks and an aging accounts receivable.


Surprise medical bills complicate things

Confusion about the amount owed and why may be most apparent when patients receive medical bills they didn’t anticipate (e.g., for out-of-network care). While 37% of patients say they would pay a surprise medical bill without question, the flip side is that 63% may not. How often do surprise medical bills happen? A national tracking poll found that one in five Americans received an unexpected charge since January 1, 2022. This happened even despite the requirement for healthcare providers to comply with the No Surprises Act (NSA), a federal law aimed at ending surprise out-of-network billing. 


Learning the lingo isn’t easy

Despite their best intentions, patients may be reluctant to pay medical bills they don’t understand. For most people, every dollar counts, and they aren’t willing to part with money if they can’t comprehend what is owed and why. For example, 77% of people misunderstand the concept of co-insurance (i.e., the portion of the bill that a health plan member splits with an insurer after the member reaches their deductible), according to a recent Forbes Advisor survey of 2,000 Americans. Nearly half don’t understand the concepts of copayments and deductibles. The survey also found significant knowledge gaps when it comes to understanding open enrollment, health savings accounts, and medical billing.


How billing clarity helps patients and practices

There are many reasons to help patients understand their medical bills. Here are a few of them:


  1. Improve the patient financial experience. Building a reputation for helping patients understand their financial obligations can help medical practices attract, engage, and retain patients. Billing with empathy is key.
  2. Enhance cashflow. Patients who understand their medical bills are more likely to pay them. 
  3. Promote positive patient outcomes. About one in four adults delayed or skipped healthcare in 2022 over surprise billing concerns. By helping patients anticipate any bills they might receive—and explaining what they might owe and why—medical practices increase the likelihood that patients will seek care when they need it.


Strategies to help patients understand their medical bills

Want to help patients understand their medical bills, but not sure where to begin? Consider these simple strategies:


  1. Adopt a ‘we’re always there for patients’ mentality. It’s all about building trust. This starts with the resources you provide. For example, consider creating a glossary of healthcare financial terms or a brochure that explains basic medical coding concepts and how a bill is created. Provide these resources in multiple languages. However, acknowledge that for some patients, this may not be enough. Being able to quickly resolve any lingering confusion with responsive support via phone, chat, or text message is paramount
  2. Invest in staff training. Along the same lines, invest in staff training. Make sure front desk staff are trained to answer basic billing questions, including questions about common medical codes the practice bills and how those codes could translate to a dollar amount owed. For example, can staff explain why office visits may not cost the same amount each time? What about whether there might be multiple bills for a single encounter?
  3. Revise your patient billing statements. If you haven’t revisited the design of your patient statements in a while, now is probably a good time to do it. Do you clearly identify the date of service, provider, and a brief description of the service (or services) the patient received? It’s also helpful to indicate the cost of each separate service, the amount the insurance paid (if any) for each of those services, and the total amount the patient owes. In addition, make sure you provide the billing statement in the patient’s preferred language, if possible.
  4. Comply with the NSA. Patient education is inherent in the NSA because the federal law mandates some healthcare providers to generate a good faith estimate or approximation of charges prior to rendering a service. Ensure registration staff are armed with tools and training that can help them estimate costs.



Let’s face it: The financial side of healthcare is confusing. Unfortunately, it’s not likely to improve any time soon. The good news is that you can take proactive steps to make patients feel less anxious about their medical bills. 



Lisa A. Eramo, MA is a freelance healthcare writer who specializes in healthcare reimbursement, health information management, value-based care, and patient engagement. She contributes bylined articles to various healthcare trade publications and also assists clients with healthcare content marketing. You can reach her at or by visiting