Yes, for patients who prefer it, once the balance is final. GoHighLevel's Text2Pay sends a payment link in a conversation, and the checkout page handles the card. The bottom line: the link should go out only after insurance has paid and the patient's portion is known, and the text should say only that a balance is available, with no amount, service, or provider detail.
Why text, and for whom
A spring 2022 survey by Salucro, a vendor, as reported in an HFMA executive roundtable, found that 56 percent of respondents prefer digital billing communications such as email or text, 39 percent prefer paper statements, and 13 percent would prefer text messaging as their primary billing notification. So text is a good option for a minority, and not the only one: the practice should offer text, email, mail, and phone, as one participant in the roundtable said, with instructions for each.
When the balance is ready
The Healthcare Financial Management Association's Patient Friendly Billing project says billing communications should be clear, concise, correct, and patient friendly, and that where possible, financial information should not be discussed during the medical encounter. Its best practices for resolving medical accounts say bills should reflect the patient's responsibility after the claim has been adjudicated and applicable insurance payments and contractual allowances have been applied. A payment link sent before the claim is processed asks the patient to pay an amount that may change.
What the text says
| Say | Do not say |
|---|---|
| The practice name, and that a balance is available | The amount, the service, or the provider |
| A link to pay, and a phone number for questions | Anything about diagnoses or treatment |
| Reply STOP to stop messages | A threat about collections |
The reason for the generic wording is that a dollar amount tied to a named patient relates to payment for health care, and a lock screen can be read by someone else. The checkout page is where the amount appears, after the patient opens the link.
GoHighLevel's help portal says accounts are not HIPAA compliant by default, and that HIPAA Compliance is a paid upgrade, $297 a month as an account wide add on, that must be enabled for the agency and then configured for the sub accounts that need it. Third party guides add that the add on provides a business associate agreement, encryption, audit logging, and multi factor authentication, that the practice also needs its own agreement with the agency, and that GoHighLevel itself recommends avoiding protected health information in SMS and email even with the add on. Whether the AI features are covered by the agreement is a question to put to HighLevel in writing before any patient data reaches them.
Build it in GoHighLevel
A third party guide describes Text2Pay as a payment icon in the message composer that sends a Stripe checkout link, and GoHighLevel's Payment Received trigger page says the trigger fires for Text2Pay payments.
- Connect Stripe under Payments, then Integrations.
- Create the checkout items, such as Patient balance, with the amount entered per patient from the final statement.
- Have billing add the tag Balance final in the CRM after the claim is adjudicated.
- Build a workflow that starts on that tag and sends the generic text and link, only to patients with a documented text preference.
- Build a workflow with the Payment Received trigger that sends a receipt, removes the tag, and updates the balance field.
- Add a reminder after 14 days and a call task for billing after 30 days, with a payment plan option.
Worked example
For example, if a practice sends 400 statements a month and 20 percent of patients pay by text link within a week, that is 80 payments (400 times 0.2) that did not need a mailed statement, a stamp, or a phone call.
Mistakes to avoid
- Sending before insurance pays. The balance may change.
- Putting the amount in the text. Keep it generic.
- Texting patients who prefer paper. Offer every channel.
- No payment plan. Offer one with the link.
How this was handled before
Practices mailed a statement, then another, then called. Online payment portals followed, and text to pay is the same step on the patient's phone. HFMA's guidance on clear billing still applies to what the message and the checkout say.
What to measure after launch
Track links sent, payments made within 7 days, failed payments, and balances sent before the claim was final. Check that no link goes out before the balance is final.
Check before you switch it on
US text messages sent from a standard 10 digit number need A2P 10DLC registration. The HighLevel support portal says registration is required for texts to US recipients from 10 digit long code numbers and that toll free numbers do not require it. HighLevel's opt in guidelines also say a person cannot be forced to agree to text messages in order to submit a form, so keep the consent box optional. One compliance guide separates informational texts, which need documented consent, from marketing texts, which need prior express written consent. Ask your attorney which category your reminders fall into. Have your billing and compliance leads approve the wording and confirm that the payment page is covered by your agreements and card security rules. This is general information, not legal advice.
Questions people ask
Do patients want to pay by text?
One 2022 vendor survey found 13 percent would prefer text as their primary billing notification, and 56 percent prefer digital billing overall.
When should the link be sent?
After insurance has paid and the patient's portion is final, according to HFMA's best practices.
What should the text say?
Only that a balance is available, with a link and a STOP line.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.