Don't let your billing envelopes go to waste. Learn how direct mail inserts can boost your practice's patient engagement and revenue.
The past three years have been a true test of resilience for patients and healthcare teams. In 2023, out-of-pocket spending increased by 7.2% to $505.7 billion, and approximately 41% of U.S. adults now carry medical debt. Nearly 4 in 10 insured Americans have even skipped care due to cost increases. Given the state of the healthcare environment, including rising patient responsibility, reduced practice budgets, and digital overload, every billing envelope can become a key touchpoint. If you're already mailing bills to patients, why not make that envelope do more by adding direct mail inserts for patient engagement, education, marketing, and revenue cycle optimization?
The Untapped Power of Direct Mail Inserts
Despite living in a digital world, direct mail proves remarkably effective in healthcare communications. While the average email open rate is approximately 21.5%, mailed items have an open rate of around 90%. The average direct mail response rate across industries is 3.63%. This effectiveness isn't just speculative. 78% of consumers are likely to open or read a direct mail piece with an offer or promotion, and around 55% of consumers visit the sender's website after receiving direct mail. Patients who receive engaging direct mail inserts may be more likely to visit your patient portal, explore payment options, or engage with your practice's digital resources.
But what exactly is a direct mail insert in healthcare billing? Direct mail inserts are any additional piece of marketing, educational, or engagement material included with regular patient statements. These inserts use the existing envelope to deliver targeted messages that can influence patient behavior, increase collections, and promote services.
Why direct mail inserts remain effective even in a digital-first world:
- Tangible presence: Physical mail demands attention in ways digital communications can't always match
- Preferred medium for many patients: 58% of practices rely primarily on paper billing, and many patients (especially seniors) still prefer a letter in hand
- Digital confidence gaps: Nearly 40% of Americans over the age of 70 do not have a great amount of confidence in their digital skills, so for those in this group, paper statements are more than extra paper
- Already established delivery system: You're already paying for postage and processing; inserts can maximize that investment
Unlike standard direct mail campaigns, patient statements represent important communications that patients need to open and review. This type of engagement enables the delivery of additional messages without competing for attention in the mailbox. Direct mail inserts in patient statements represent a unique form of communication that blends the reliability of traditional mail with the accuracy of digital marketing. Unlike independent marketing materials that might be quickly discarded, direct mail inserts benefit from the importance of the patient billing statement. Patients who receive paper bills and open them will be instantly engaged with the practice.
5 Ways to Turn Your Inserts Into Strategic Tools
Below are five ways that can transform direct mail inserts from “extra paper” into strategic tools:
1. Educate Patients About Payment Options
Many patients receive medical bills but struggle to understand their payment options(such as how and where to pay), leading to delayed payments and multiple phone calls to the billing department. Instead of leaving patients to learn their payment options on their own, the billing envelope can be used to highlight available options. This proactive education helps patients understand their options before confusion sets in.
Consider including explanations of online payment portals, automatic payment enrollment, payment plan options, and step-by-step instructions for different payment methods. Visual guides showing how to use online systems, QR codes linking directly to payment portals, and timelines for when payments are due can turn their experience into a straightforward one that empowers them to continue to take control of their medical bills.
2. Promote Flexible Financing
Economic pressures have made medical debt a significant concern for many patients. A recent study found that about 1 in 5 people received a medical bill they disagreed with or couldn't afford. However, many patients don't seek help, with about 86% of them believing it wouldn't make a difference.
Still, a 2024 survey found that 80% of respondents said they want the ability to pay a bill in installments (and 60% admitted they cannot afford an unexpected medical expense in one lump sum). Practices are responding to this need, with an MGMA survey finding that 41% of medical groups updated their patient payment plans or options in the past year.
Direct mail inserts offer a non-confrontational way to introduce details about financial counseling services, flexible payment plans, or other extended payment options. One of the keys to successful financing promotion is to position these options as patient-friendly solutions. Use language that emphasizes your support for the patient. For example, you can try, “Ask us about splitting your payment into as many as 3 months interest-free!”
BillFlash FlexPay is one of the financial solutions you can highlight through an insert. FlexPay allows patients to pay over time with no hard credit check and guaranteed 0% interest options for all approved patients, while your practice still gets paid in full upfront. Patients learn about it when they're already thinking about their bill, so the timing is perfect.
By turning every mailed statement into an opportunity to highlight financing support, you demonstrate to your patients that you understand their realities and are prepared to support them.
3. Encourage Patient Online Portal Payments
Although a secure patient portal or online bill pay system is a great convenience, many patients never use them. Approximately 90% of providers now offer portals, but fewer than one-third of patients access them. Direct mail inserts can help connect physical mail with digital platforms. For example, a QR code that links to your patient portal. Adding a QR code on the mailed statement or insert encourages patients to use your online portal or payment site, meeting them halfway.
A Consumer Action survey found that 74% of people prefer to receive medical bills by mail, but 55.5% said they prefer to pay their bills online. So, patients want the trust of a paper bill and the convenience of digital payment. An insert can say: Visit our patient portal or scan this QR code to view and pay your statement securely at your convenience. This helps accelerate the patient's payment, which can enhance revenue collection.
Your direct mail inserts can also communicate the payment options available through your payment portal. For example, PayWoot offers credit and debit card options, as well as eCheck, AutoPay, PlanPay, and FlexPay. Adding a How to Pay Online section can remove obstacles for patients who may be hesitant about using online portals to make payments.
Your How to Pay Online guide might include:
- Visit PayWoot.com or scan the QR code
- Create an account or use Guest Pay
- View your current balance and statement details
- Select your preferred payment method (card or eCheck)
- Choose to pay in full, apply for financing, or schedule automatic payments
This approach transforms your insert from a portal promotion into a guide that addresses common concerns about online payments while highlighting the convenient payment options available.
4. Deliver Seasonal or Practice-Specific Messaging
Healthcare needs change throughout the year, and your direct mail inserts can help patients manage important health activities. Use seasonal messaging to promote flu vaccinations in the fall, skin cancer screenings in the summer, or wellness visits at the beginning of the year. Research has shown that sending one written message increased influenza vaccination rates by 16% compared to no reminder. These health prompts show you care about patient well-being, not just collecting their payments. Season-specific inserts can be brief (Did you remember your flu shot? We still have slots available). The key is to catch the patient when the matter is fresh and link it back to your practice. Practice-specific messaging helps build stronger patient relationships while promoting additional services.
5. Free Marketing Tool
Remember that any insert is free marketing. Postage is already paid, so an insert is a bonus flyer inside the envelope. Healthcare marketers place direct mail at the top of their list. In one survey, 91% of marketers reported that direct mail had the best response rate of any channel, and 78% indicated it had the best return on investment. So, every envelope is a marketing opportunity you're already using. Use this extra opportunity to build your practice's brand, promote services, or include a patient satisfaction survey or payment coupon. Direct mail inserts can also be promotional, highlighting offers such as prompt pay discounts or special discounts on services like annual wellness exams. The key is relevance. Match your promotional messages to your patients' needs.
Best Practices for High-Impact Inserts
Creating effective direct mail inserts requires attention to design, messaging, and timing. Your inserts should feel like natural extensions of your practice's communication style, not obvious marketing materials. Stay consistent with your brand guidelines, including colors, fonts, and tone of voice. To ensure your patient statement inserts are effective, keep messages clear and straightforward. Patients reviewing medical bills are often focused on payment information, so your additional messaging needs to be immediately understandable. Bullet-point lists, infographics, or brief announcements are most effective because many patients may prefer to avoid reading dense text.
Focus each insert on a single topic—such as payment options or flu shot basics—and ensure the headline is clear and informative. Avoid medical jargon and complicated terminology that might confuse patients. Visual elements can significantly enhance the effectiveness of direct mail inserts. Include applicable images, charts, or infographics that support your messaging. QR codes serve as effective links between print and digital communications. They enable patients to quickly access online resources, payment portals, or additional information.
Every insert should include a clear call to action. Whether you want patients to visit your website, call your office, or schedule an appointment, make the next step obvious and easy. Use language like Call Today, Visit Now, or Schedule Online. Include specific contact information. Once you get started, we encourage you to try different approaches to improve the performance of your inserts. Try changing your messaging, design elements, or timing to see what connects with your patient population. Track metrics like website visits, portal sign-ups, or appointment scheduling that can be attributed to your insert campaigns.
Maximizing the Impact of Each Mailed Statement With BillFlash Inserts
If you're ready to implement direct mail inserts, BillFlash makes it easy to capitalize on this opportunity with BillFlash Inserts, a component built right into the BillFlash portal. Every time you send a bill, you have a built-in opportunity to communicate more than just a balance due, and BillFlash Inserts help you make the most of it. These customizable inserts turn normal billing into a cost-effective marketing tool. In a few clicks, you can upload your pre-designed PDF flyer or create a quick announcement. There is no extra postage or hassle.
Whether you're sharing updates, promoting new services, or providing information on flexible payment options, inserts can be easily uploaded and scheduled to pair with the right patient statements. Fully integrated into your billing workflow, BillFlash Inserts ends the need for multiple vendors and manual processes, making every bill a smart touchpoint that strengthens patient relationships.
Don't Waste the Envelope
Don't let your billing envelopes go to waste. With patients opening most mailed statements and many facing higher expenses, every bill presents an opportunity to educate and reassure. Well-crafted direct mail inserts can help boost collections, strengthen loyalty, and increase revenue—all without additional postage or effort. Take advantage of this free real estate in the envelope. You can remind patients of their options, invite them online, and show you care.
Are you ready to maximize every envelope? Schedule a demo with BillFlash today and see how easy it is to add custom inserts, streamline your billing process, and accelerate patient payments—all in one platform.