Healthcare providers can issue fewer paper checks and streamline the patient experience by offering a digital payments menu with electronic patient refund options.
Working from a digital payments menu, patients can select the healthcare refund payment methods they prefer, such as ACH, Zelle, the RTP® network, push-to-card and prepaid card.
The bank retains the patient’s payment preference, so next time the patient is owed a refund, the bank already knows which payment method to use.
In today’s world of healthcare treasury management, two goals topping the lists of most executives are “maximizing process efficiency” and “improving the patient financial experience.”
Now there’s an easy way for healthcare providers to do both — a banking solution that eliminates the need for providers to issue patient refund checks.
Most providers deliver well over half of patient refunds to the original method of payment, usually a payment card on file. The revenue cycle management team initiates card refunds, and the accounts payable unit issues paper checks for the remaining refunds.
Jessica Schopp, Head of Healthcare Products and Technical Sales for U.S. Bank Treasury and Payment Solutions, serves a large healthcare provider that sends about 300,000 statements (bills) to patients each month. Only about 8,000, or less than 3%, result in the need for a patient refund, for reasons ranging from overpayment to billing adjustments to coding errors, she says.
Of those 8,000, about 5,500 — almost 70% — get refunded back to the patient’s card, leaving the provider’s accounts payable staff to issue about 2,500 patient refund checks a month.
That may not seem like a big number. But the possibility of eliminating the issuing of those checks offers a major opportunity for the provider to redeploy staff to other tasks and give patients the kind of fast, convenient healthcare refunds they have come to expect as consumers.
So, Schopp asked a simple question: “How can we improve the refund experience by offering flexible digital options that reflect what patients increasingly expect?”
"With patients paying more out of pocket, financial experience is increasingly viewed as part of the overall care experience, and patient satisfaction with financial interactions matters more than ever."
A growing number of banks now offer a solution for closing that loop. It includes using an electronic disbursement platform with a digital payments menu that allows providers to give their patients a choice about how they will receive their healthcare refund payments, including through various electronic payment methods.
With this solution, the provider sends a refund payment instruction to its bank detailing which patient to pay, the amount of the payment and the patient’s email address. The patient then receives a provider-branded email asking them to visit a provider-branded website where they can enroll and select a payment method for their healthcare refund. Typical options include an ACH to their bank account, Zelle®, the RTP® network, push-to-card or a prepaid card. With most of these solutions, you can include paper check as a patient refund option, but it’s not required.
Every patient that selects an electronic payment option represents one less refund check. What’s more, this type of solution retains information on the patient’s payment preference, so the next time the patient is owed a refund, the bank already knows which payment method to use without asking again.
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If the patient does not enroll, usually the default is to send the patient a check. But issuing and delivering that patient refund check becomes the bank’s job — because with the payments menu solution, the healthcare provider outsources that task to the bank.
By reducing the volume of patient refund checks issued, the provider mitigates check fraud risk, reduces costs associated with issuing and mailing checks, and can reassign accounts payable staff to other duties. Plus, patients get their healthcare refunds faster and don’t have to spend time depositing a check, which improves their financial experience. “With patients paying more out of pocket, financial experience is increasingly viewed as part of the overall care experience, and patient satisfaction with financial interactions matters more than ever,” Schopp notes.
A digital payments menu will reduce the need for patient refund checks, but it won’t eliminate them, and some will need to be escheated, she says. As a result, providers can create even more efficiencies by adopting a bank automated escheatment service that performs the duties related to managing healthcare refund checks that go uncashed.
Several states have enacted laws dictating how healthcare organizations manage and issue patient refunds, with a recent trend toward stricter, faster turnaround times. These laws generally aim to protect consumers from overcharges and excessive delays in returning credit balances.
For example, Florida legislation that went into effect on Jan. 1, 2026, requires healthcare providers and facilities to refund patient overpayments within 30 days of identifying them.
Offering patients a digital payments menu with faster payment options — including instant payment methods like RTP and Zelle — can speed the delivery of patient refund payments and help providers avoid disciplinary actions, fines and reputational damage.
The most effective way to reduce patient refund check volume is to get as many patients as possible to pay their medical bills by card or some other electronic option on the provider’s online portal. That way the refund can be delivered over that same efficient payment rail.
However, in your medical billing refund process, every patient won’t opt to pay on a portal, and as a result, some healthcare refunds will have to be delivered by other means. That’s where a digital payments menu can support a better refund solution. It reduces the need for refund checks and enables a provider to outsource any remaining check-issuance duties to its bank. This gives patients the type of convenient digital refund most prefer and appreciate while unburdening accounts payable staff.
Our healthcare industry experts understand the nuances of your business and stand beside you to help your financial operations run smoothly. No matter where you are on your journey toward digitizing the revenue cycle, contact a knowledgeable banker to learn about helpful tools that can enable you to accelerate the process.
Establishing, communicating and following a clear and efficient medical billing refund process and policy enables healthcare organizations to maintain regulatory compliance, ensure financial accuracy, and foster patient trust and satisfaction. A healthcare refund policy can reduce administrative burdens, prevent costly penalties under patient-refund laws, and enhance the overall patient financial experience.
Patient refund laws on the books in several states dictate the timeframe and method for issuing refunds. Digital solutions ensure compliance by automating the process and providing detailed records.
By implementing a digital payments menu, providers can offer multiple patient refund options, such as ACH, Zelle or push-to-card, reducing the need for paper checks.
Healthcare organizations are automating manual processes to boost efficiency and enhance revenue cycle performance.
As healthcare financial services evolve, you need healthcare payments solutions that enhances your patient experience and improves the medical billing process.
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