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Four Essential Elements of an Effective Patient Refunds Solution

Providers are experiencing a growing number of refunds and other B2C (Business-to-Consumer) payments. The rise is being fueled by increasing levels of patient self-pay for care, greater deployment of preservice estimates, and continuing complexity of payer reimbursement policies. These factors can generate overpayments that necessitate refunds.

Today’s refund process remains highly manual and is often plagued by backlogs arising from high volume of small dollar refunds. Costly paper checks still abound. Further complexity is caused by the detailed document attachments that frequently accompany payments.

Overcoming these administrative burdens is a valuable task. It contributes to two of the most pressing healthcare priorities, namely, rigorous cost control and substantial improvement of the patient financial experience to meet consumer and competitive demands.

Fortunately, there is a solution. Its centerpiece is a refund management program containing four essential, connected features.

Outsourced automation of the end-to-end process to generate cost savings and operational efficiencies.

B2C payment solutions such as PreferPay® from CommerceHealthcare® assume complete life cycle management of a provider’s refunds to patients and insurers. The platform’s automation streamlines the process for all. The provider’s system directs a refund request to PreferPay®. Commerce Bank communicates electronically with the patient to gather account data, issues payment in one of four ways according to patient choice, and returns reconciliation information. CommerceHealthcare® manages any check escheatment issues. Multiple payments and/or supporting documentation for insurance companies and commercial accounts can be automatically batched to generate additional efficiencies.

Expanded choice, speed and convenience to enhance the patient financial experience.

Patients increasingly expect options and convenience in their healthcare encounters. A Harris Poll found that 61% of consumers “would like their healthcare experience to be more like the customer experience of an online convenience service app.”1 The PreferPay® platform lets individuals select from four refund payment modes: direct to debit card, direct deposit, electronic check, or paper check. The electronic options put refunds in patients’ hands quickly. Patients use simple, well-designed software accessible on computers or smartphones. They are not required to create and manage an account, username or password, removing further friction from the process. The result is a better overall financial experience.

An integrated, cloud-based platform to ensure a solid payments technology foundation.

A good refund management solution integrates with a provider’s EHR, financial and patient management systems via Application Programming Interface (API). CommerceHealthcare® is committed to an API-first approach, which has become the preferred mode in healthcare IT, while also supporting file transfer options. Specific prebuilt data extracts ensure synchronization with Epic, Meditech and numerous other systems.

Strong security is vital in a payment platform, which is why CommerceHealthcare® has opted to deploy PreferPay® as a private cloud, hosting the portal and storing customer data behind the bank’s firewall. Multifactor authentication by phone and text message is used in patient communications to bolster the system security profile.

A strong, experienced financial provider to gain long-term benefits.

Technology is only half the equation. Healthcare leaders see great value in teaming with external providers who bring reliability, financial stability and experienced healthcare professionals to support their systems for the long term. CommerceHealthcare® meets this client need with experience derived from serving over 500 health systems, hospitals and medical practices. Using data, ongoing surveillance, and disciplined operational reviews, these professionals are able to serve as trusted advisors. They bring the financial strength of Commerce Bank, which ranks in the top 50 banks in the country by asset size and in the top 5 by Moody’s for standalone credit strength.2

Take the next step.

To learn more about the four key elements of a strong refund management and B2C payment program, how organizations are using the solution and the benefits you can derive, please reach out to us. Visit Patient Refunds | CommerceHealthcare®.


  1. Tegria, “New Data Finds 69% of Americans Would Consider Switching Healthcare Providers for More ‘Appealing’ Services,” February 15, 2022.