Learn more as we discuss what EBPP is, how it works, and why it has become a key strategy for modern healthcare practices.
Modern practice leaders are facing financial pressures, heavy administrative workloads, and labor shortages that threaten their stability. According to the MGMA, 92 percent of medical group leaders reported that their operating expenses increased in 2024, a trend driven by labor costs, inflation, and reimbursement pressures. This environment of rising costs and fewer staff creates a challenge: practices have to find new ways to do more with less. Because of this, practices are increasingly turning to solutions like Electronic Bill Presentment and Payment (EBPP) to streamline one of the most demanding—and essential—workflows in healthcare: patient billing.
Relying solely on traditional, paper-based billing is no longer sufficient. As patient financial responsibility increases, the average patient has been responsible for $1,650 in out-of-pocket costs in 2025. As a result, practices' revenue cycles have been dependent on collecting smaller, individual balances. But industry payment systems have not changed with this shift. 71 percent of providers still rely on paper and manual processes to collect from patients, contributing to the 50 percent of providers who struggle with large, outstanding patient balances.
This workflow is not only inefficient, but it also affects patient care. According to the Physicians Advocacy Institute, 80 percent of physicians say their patients delay or avoid care due to cost concerns. When billing systems are slow, confusing, or inconsistent, patients get into debt, practices lose revenue, and both sides become frustrated. This loop, where outdated billing processes create patient debt, leads to more canceled appointments and poorer health outcomes.
Reducing Administrative Burden
Practices continue to feel trapped, spending their most valuable resource (staff time) on their least effective activity (manual billing). The solution isn't abandoning paper entirely, but giving practices and patients a choice. Electronic Bill Presentment and Payment (EBPP) is one such choice. It is a smarter, faster, and more patient-friendly method that replaces manual steps with automated digital workflows, reduces administrative burden, improves cash flow, and delivers the payment experiences patients expect.
Today, we will explain what EBPP is, how it works, and why it has become a key strategy for modern healthcare practices.
What Is Electronic Bill Presentment and Payment (EBPP)?
Electronic Bill Presentment and Payment (EBPP) is the digital delivery and collection of bills. It has two core functions:
- Presenting bills digitally. Patients receive their statements by email or text message with a link to a secure online portal, rather than waiting for paper mail.
- Enables secure online payments. Patients can pay immediately using a credit or debit card or an electronic bank payment, without writing checks or calling the office.
A complete EBPP solution automatically generates statements, sends digital notifications, processes payments, and posts them directly into the billing software without staff intervention. This is not just about digitizing a paper bill; it is about changing the entire financial experience. EBPP bridges the gap between what organizations need (i.e., faster, more predictable revenue) and what consumers expect (i.e., convenience, clarity, and control). It also replaces slow processes with automated digital systems that work around the clock, reducing delays and eliminating much of the manual effort that slows down staff.
How EBPP Works in Healthcare Settings
The EBPP cycle follows a straightforward path from bill generation to payment confirmation:
1. Bill Generation: The practice management system or billing software creates a patient statement based on services rendered, insurance adjustments, and patient responsibility.
2. Digital Delivery: Instead of printing and mailing the statement, the system sends a text message or email to the patient. The message can include a secure link inviting them to view and pay their bill online.
3. Patient Review: The patient clicks the link and lands on a secure payment portal. There, the patient can review their bill in detail. This includes seeing line items and the total amount due.
4. Online Payment: The patient chooses their preferred payment method and completes the transaction directly through the portal. The payment processes instantly, and the patient receives confirmation.
5. Automated System Updates: Payment data flows back into the practice management system automatically. Account balances also update in real time, eliminating the need for manual posting and reducing the risk of errors.
This type of automation replaces tasks that once consumed hours of staff time. No more printing thousands of statements, addressing envelopes, making follow-up calls about missing payments, or manually entering check amounts into the system. The digital workflow handles it all. But automation is only one part of the EBPP experience.
The next step is how those digital statements reach patients, and EBPP supports different delivery channels:
- Text messages with secure payment links for quick mobile access
- Email notifications with secure payment links
- Secure patient portals where patients can log in to make a payment
Each channel meets patients where they already are, making it easier for them to act quickly and reducing the friction that leads to delayed payments.
Why EBPP Matters for Today's Medical Practices
Adopting this system is not a minor upgrade; it is essential for patient retention and financial survival. The reason is a growing disconnect between what patients expect and what most practices deliver. It is important to remember that patients are also consumers. In every other part of their lives, from banking to ordering food, they are served by digital-first experiences. The healthcare industry, however, has fallen behind, creating an expectation gap.
This gap is widened by staff shortages, which leave practices without the staff needed to manage manual, time-consuming billing workflows. 48 percent of providers say shortages and labor costs are among their biggest hurdles. When practices are understaffed and overwhelmed, the disconnect becomes even more visible to patients, who now compare healthcare billing to every other digital-first experience in their lives. 60% of consumers state they expect their healthcare interactions to mirror the seamless experiences they get from retail giants. Their expectations for billing are also very digital. For example:
- 85% of consumers prefer using an electronic payment method
- 66% of patients prefer email or text message notifications for billing reminders
The provider reality, however, tells a different story:
- 71% of providers still collect from patients using paper and manual processes.
- Many patients still receive paper bills that often arrive weeks or even months after care was delivered, creating a disconnect from the service and leading to confusion.
How the Expectation Gap Affects Patient Experience
This expectation gap is not a small inconvenience. It is a main driver of frustration and patient loss. Patient experience was once measured by quality, while billing was a separate back-office function. Today, due to the rise of high-deductible plans and healthcare consumerism, a patient's financial experience has become a key component of their overall experience. One poor billing experience can undo all the good a provider did in the exam room because:
- 63% of patients would consider switching providers for a better payment experience
- 50% of patients say a single bad digital interaction is enough to ruin their entire relationship with that provider
- 53% of patients who had a negative financial experience with their provider reported leaving a negative review
EBPP matters because it addresses both a practice’s internal problems and the patient’s external needs. It closes the expectation gap by providing the digital-first communication and self-service portals that patients want.
Key Benefits of EBPP for Healthcare Practices
When a practice implements an EBPP solution, the benefits are measurable across the entire revenue cycle.
Faster Payments
Data shows that 32% of patients will pay their medical bill within 5 minutes of receiving a text notification, and 25% will pay within 5 minutes of receiving an email notification. This reduces the payment cycle from weeks to minutes.
Lower Administrative Burden
By automating manual billing, payment, and posting, EBPP frees staff from repetitive tasks. This aligns with findings from healthcare automation, demonstrating that automation significantly reduces administrative burdens. This allows the front office to focus on patient care and high-value financial activities.
Improved Accuracy
Manual data entry is a primary source of billing errors. EBPP systems reduce manual errors by automating data transfer and payment posting. This leads to fewer billing disputes, cleaner data, and less rework.
Better Patient Experience
A simple, clear, and convenient process makes patients happier, more satisfied, and more loyal. A positive payment experience is now a key retention strategy in modern practices.
Better Tracking
Digital systems create a complete and real-time audit trail. Practices can track when a bill was sent, when it was paid, and how it was paid, giving greater visibility into cash flow and eliminating guesswork.
Patient Benefits: Convenience, Transparency & Flexibility
The reason EBPP is so effective for practices is that it is a solution patients prefer, and for many reasons.
Patients Receive Bills Through Preferred Channels
EBPP meets patients on the devices they check most. This aligns with their expectations, since 59 percent of patients would prefer a billing notification via text message, and 66 percent prefer either email or text for billing reminders.
They Can Review Charges, Pay Instantly, and Avoid Surprises
A quality EBPP solution allows patients to see a clear breakdown of their charges. This transparency reduces the confusion many patients experience about their bills and the stress they face when paying them.
Increased Trust and Satisfaction
A simple, transparent, and professional billing experience demonstrates that the practice is modern, efficient, and respects the patient's time.
EBPP in Action: How BillFlash eBill Notices & PayWoot.com Improve the Billing Experience
A modern EBPP system becomes most meaningful in actual practice settings. BillFlash provides a clear example of an EBPP workflow that improves patient communication, speeds up payment cycles, and reduces administrative burden without disrupting existing processes. For instance, BillFlash's eBill Notices send secure links through text and email, directing patients to a secure portal where they can view their statement. When a patient receives this HIPAA-compliant notification and clicks the secure link, they are taken directly to PayWoot.com.
This portal is designed for simplicity, and:
- Patients can view their eBill, see their payment history, and pay 24/7.
- There is no app to download, which removes a common point of friction.
- Patients can use GuestPay for a fast, one-time transaction or create an account to securely store payment methods for future use and view transaction history.
The results of this digital workflow are evident. On average, practices that combine BillFlash eBill Notices with their mailed bills see their average days to payment decrease from 20 to just 9. This digital-first approach also frees up the front office, as staff no longer need to complete payments manually.
A great system also recognizes that not all patients will go digital overnight. BillFlash complements digital notices with professionally mailed paper statements with a QR code. A patient who receives a paper bill can scan the code with their smartphone and be taken to the same portal (PayWoot.com) to pay online. This model creates a digital bridge, ensuring the practice can serve all patient preferences while consolidating payments into a single, efficient, automated, and easy-to-use system.
How EBPP Supports a More Efficient Revenue Cycle
An effective revenue cycle management process is about getting paid in full, as quickly as possible, with the least amount of friction. EBPP helps drive the back-end of a modern revenue cycle.
Fewer Manual Tasks Lead to More High-Value Time
By automating the low-value, repetitive tasks of statement delivery and payment posting, EBPP enables billing staff to focus on revenue-generating activities.
Reduced Aging A/R and Smoother Reconciliation
The biggest threat to a practice's cash flow is aging A/R. Claims over 90 days old have a very low chance of being collected. When many providers are already waiting over 30 days for payment, revenue is already in a danger zone. EBPP helps prevent A/R from aging by sending digital reminders immediately after the visit, keeping the bill top of mind so patients view and pay before it becomes a collections issue.
Greater Accuracy and Fewer Billing Disputes
Clear, transparent e-statements combined with fewer manual entry errors mean fewer “I have questions about my bill” phone calls. This also reduces staff burden and billing disputes, speeding up the path to payment.
Better Financial Predictability
When a practice's average payment cycle drops from an unpredictable 30–45-day window to a reliable average, cash flow becomes predictable. This allows practices to manage budgets, make payroll, and invest in growth with confidence.
EBPP Is No Longer Optional—It's Essential
Electronic Bill Presentment and Payments represents more than just a change. It's a shift in how practices and patients interact around one of healthcare's most sensitive topics: billing. Slow, manual processes create administrative burdens for staff, and they deliver a poor financial experience that frustrates patients so much that many would switch providers to avoid it. EBPP streamlines billing through automation, reducing administrative costs and removing manual errors. It also improves cash flow by speeding up payments. Most importantly, it improves patient satisfaction and loyalty by offering transparent and convenient digital options that patients expect.
Ready to simplify billing, accelerate payments, and give your staff time back? Schedule a demo with BillFlash today to see how our integrated billing, payment, and collection software helps practices get paid faster, while delivering a better patient experience.