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From Confusion to Collections: How Unclear Billing Fuels the Medical Debt Crisis

by Steve Callis, President of Payments, RevSpring 12/12/2025 Leave a Comment

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Steve Callis, President of Payments, RevSpring

Medical debt remains a significant burden for patients nationwide, with U.S. residents collectively owing an estimated $220 billion. Medical visits already bring emotional and financial stress, and confusing bills only make matters worse. When patients receive statements that they don’t understand, or multiple, fragmented bills, they’re left frustrated, less likely to pay on time, and are at greater risk of accumulating medical debt.

While the July 2025 ruling striking down the Consumer Financial Protection Bureau’s (CFPB) plan to erase medical debt from credit reports grabbed our attention, it doesn’t address the root of the issue. Just under half of U.S. adults already struggle with healthcare costs, and one in four report having trouble paying medical bills in the past year. This underscores the importance of clear, timely communication about medical bills. Delays caused by unclear billing turn manageable balances into bad debt long before they ever reach a credit score. The real fix lies in delivering personalized, easy-to-understand communications through a single, unified platform that ensures patients see a complete and consistent picture of what they owe and when.

The communication breakdown that costs patients and providers

Payment delays are often driven by jargon-filled bills, outreach that doesn’t adhere to patients’ preferred channels, and inconsistent access to digital tools. Studies show that patients struggle with understanding prior authorizations and billing details, which often leads to frustration and delayed payments. Moreover, poor communication can drive many patients to consider switching providers altogether, eroding patient trust and increasing financial strain on healthcare organizations. 

When each billing touchpoint feels disconnected (through various formats and different messaging), patients lose confidence. This broken communication can cause financial burdens for the patients, while also directly impacting hospital and health system finances. A unified approach to patient communications can eliminate inconsistencies, making every interaction feel coordinated and intentional, in turn helping patients’ propensity to pay their bills on time and therefore increasing the hospital’s bottom line.

What effective communication on healthcare finances and affordability looks like

Simple, straightforward communications support patients in resolving their balances. Using plain language and clear statements while avoiding complex medical or financial jargon is one strategy to increase patient understanding. Additionally, maintaining consistency across email, print, SMS, and portal communications helps keep communications comprehensible. Utilizing a single platform can ensure this messaging is not only consistent but also tailored to patient preferences for tone, channel, and timing. Personalizing interactions gives the patients  clarity and control over these scenarios, supporting their likelihood of paying a balance.

It’s also important to assess population demographics and preferences when applying communications strategies. Different demographics have varying preferences. Some favor digital channels and payment options, while others still prefer traditional paper notices delivered by mail. Empowering healthcare staff to have direct conversations around patient preference can also be helpful to adjust and inform future interactions.

Further, it’s important to meet the patient where they are financially. Giving them options for how, when, and where they submit payment for their healthcare can help to eliminate confusion, friction, and bad debt scenarios. Opportunities for this level of personalization can happen across the healthcare continuum: pre-service, patient intake, point of care, post service or in the back office. With the rise of alternative payment methods like Apple Pay, Google Pay, PayPal, and Venmo, offering choice has become even more critical, especially as younger generations increasingly favor these options.

How digital tools can help prevent bad debt

The right tools support automated reminders and flexible payment plans, allowing patients to act sooner. When these capabilities live within one integrated system, patient histories, preferences, and balances are centralized, enabling timely outreach, ideally leading to earlier payments and fewer accounts in collections. Consolidating tools help organizations gain both operational efficiency and a more holistic understanding of the patient, which improves results on both sides of the balance sheet.

The right tools prioritize patient understanding and seek to coordinate between the clinical and financial outcomes impacting their care. One tool currently being used as a powerful engagement driver is artificial intelligence (AI); however, these tools must be used with sensitivity. When connected to a unified system, AI can leverage a full view of patient data to deliver relevant, trustworthy interactions that are connected to prior conversations. The technology should always act as an assistant to staff, rather than a replacement for continued empathetic financial engagement with patients.

Hospitals and health systems must take shared ownership of the medical debt challenge by simplifying billing, adopting digital engagement, and leveraging data-driven insights to guide patients toward manageable payment options. Personalized messages, often supported by technology, ensure that every communication is clear, consistent, and patient-centered. This proactive approach reduces bad debt at its source, improves cash flow, and can help protect patients from financial hardship.


About Steve Callis
As President of Payments at RevSpring, Steve Callis leads the vision, integrated product strategy, and strategic partnerships for merchant and payment software solutions. Steve has a proven track record for building and managing high-performing teams to deliver transformative integrated payments solutions that drive results for clients. He is a payments industry veteran with more than 20 years of leadership experience, including within the healthcare industry. Prior to joining RevSpring, Steve led the integrated payments businesses and market strategies with several payments industry leaders, including Elavon, EVO Payments International and Global Payments.

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