Insights Revenue & Payments 7 min read

The old way of getting paid is broken. This is what's replacing it.

M
Monica Bolbjerg, MD
Founder & CEO, Qure4u
PublishedJune 8, 2026
From the desk of the CEO

"The money is already owed. The problem was never intent — it was friction."

Balance due — pre-visitTAP TO PAY · APPLE PAY
$142
Paper statementUNOPENED · DAY 24

A patient walks in. Staff know there is an outstanding balance. Nobody brings it up. The patient leaves. A paper statement gets mailed weeks later, lands on the kitchen table, and nobody opens it. Nobody pays it.

This is not a story about patients who don't want to pay. It is a story about a payment system so broken that even patients who fully intend to pay often don't. And the cost to healthcare providers is enormous.

01 — The frictionWhy the current system fails both sides

Healthcare is the only industry that still relies on paper statements, confusing billing codes, and phone calls as its primary collection mechanism. Think about how you pay for everything else — groceries, flights, streaming. You don't wait for a letter or navigate a phone tree. You tap your phone and it's done. Healthcare never made that leap, and providers are paying the price.

Here is how the collection sequence typically plays out:

  1. The balance walks out the door. Front desk staff don't raise the outstanding balance — it's an uncomfortable conversation — so nothing is collected at check-in.
  2. The patient is seen. Service is delivered. The patient leaves.
  3. Claims are filed. Insurance adjudicates, and patient responsibility is finally determined.
  4. A paper statement is mailed — often weeks later.
  5. The statement is confusing. Billing codes, adjustments, amounts that don't match expectations. To pay, the patient must mail a check, hunt for a portal password, or call a number that puts them on hold.
  6. Most patients complete none of those steps — not because they're unwilling, but because it's too hard.
  7. The practice sends more statements, makes follow-up calls, and eventually writes off the balance.

This is the cycle draining provider revenue across every specialty, every market, and every size of practice. And it is entirely preventable.

The difference between collecting 99% and collecting 25% is not patient intent. It is payment friction. — On what actually moves collections
02 — The data

Collection rate is a friction problem, not a willingness problem.

The pattern is consistent across our customer base: the easier you make it to pay, the more reliably patients do.

Frictionless pre-visit payText, one tap, Apple Pay / Google Pay, no login
99%
Automated text outreachPost-visit balances, paid within 30 days
70%
Statements & billing callsBalances over 90 days
<25%
$1M+

Collected in the first month by a single department after switching to text-based collections. Another practice turned on PostPay and collected $18,000 on day one.

Source — Qure4u customer data

03 — The uncomfortable truthStop coaching staff on a broken workflow.

Ask any practice manager and they'll tell you the same thing: front desk staff don't like to ask about money. It's awkward, patients push back, and the balance walks out the door with them. This isn't a training problem — it's a design problem. The system was never built to make it easy for patients to pay at or before the point of care, so it doesn't happen consistently, no matter how well the front desk is trained.

The solution isn't to coach staff harder. It's to remove the conversation from the workflow entirely.

04 — The fixTwo products. Zero awkward conversations.

FastPay

Collect before patients walk in.

When a patient schedules or confirms an appointment, they get a secure text with everything they need to prepare financially — no login, no app, no paper, no front desk conversation.

  • Outstanding balance, looked up in real time from your billing system
  • Credit card on file request
  • Insurance card and ID capture
  • One-tap payment via Apple Pay, Google Pay, or card
Patients arrive already paid. Across specialties, FastPay customers see 99% of expected pre-visit copays and balances collected before the appointment begins.
PostPay

Close every balance that slips through.

For balances determined after insurance adjudicates, PostPay takes over the moment a balance is ready — and sends the patient a text instead of a statement.

  • Their exact balance, in plain language
  • A direct payment link with Apple Pay and Google Pay
  • The ability to set up a payment plan if needed
  • Sequenced follow-ups if the first message goes unanswered
No statement to mail, no call to make, no portal to navigate. 70% of invoices reached through PostPay are paid within 30 days. For chronic non-payers, practices can require resolution before future appointments are confirmed.

05 — The economicsYou keep 100% of what you collect.

Here's the part that surprises most providers: Qure4u doesn't take a transaction fee. Many collection tools take a percentage of every dollar collected — meaning the better the tool performs, the more it costs you. That's a misaligned incentive.

FastPay and PostPay operate on a fixed flat fee per provider per month. You always know exactly what you're paying, and every dollar collected is yours.

06 — The proofReal results from real customers.

These aren't projected outcomes — they're results from our customer base.

$18K
Collected on day one after a practice turned on PostPay.
$1M+
Collected in the first month by a single department.
99%
Pre-visit collection rate across primary care, oncology, cardiology, and more.

As one customer put it: "If we don't get paid before the visit, we may never see that money." FastPay makes sure they do.

For patients who need support

Some patients genuinely can't pay in full. FastPay and PostPay include tools to support them — sliding fee schedule guidance for FQHCs and safety-net providers, payment plan setup directly in the text conversation, and eligibility-aware messaging that surfaces financial assistance for qualifying patients. The goal isn't to exclude — it's to find a path to payment that works for both sides.

07 — FAQCommon questions, answered.

How does FastPay integrate with our existing billing system?
FastPay connects with your EHR and billing workflows to look up patient balances in real time. Payments are posted back automatically — no manual reconciliation, no separate system to manage.
What happens with patients who can't pay the full balance upfront?
Both FastPay and PostPay support payment plan setup directly in the text conversation, so patients can select a plan without calling your billing team. For FQHCs and safety-net practices, sliding fee schedule guidance is built in.
Is this HIPAA compliant?
Yes. FastPay and PostPay are built for healthcare — HIPAA compliant by design, with all payment data handled through secure channels.
Do you take a percentage of collections?
No. Qure4u charges a fixed flat fee per provider per month. There are no transaction fees and no percentage taken from collections — every dollar collected stays with your practice.
How long does this take to set up?
FastPay and PostPay typically deploy in days, not months. Because they connect to your existing systems, there's no rip-and-replace required.
What if a patient ignores the first text?
PostPay includes sequenced follow-up at optimized intervals — patients who don't respond to the first message receive additional reminders automatically. For chronic non-payers, the system gives practices tools to require resolution before future appointments are confirmed.

08 — The path forwardThe money is already owed.

The old way of getting paid was built for a different era. Paper statements and phone trees were never designed to maximize collection — they were designed around the infrastructure of a world that no longer exists.

FastPay and PostPay are built for the world patients actually live in: text-based, instant, one tap, no transaction fees. A fixed monthly cost and a collection rate that changes the financial reality of your practice. The money is already owed. Start collecting it.