What Happens When Patients Pay Providers Through Their Health Plan or Health Savings Account Portal

Introduction: The Convenience Shift Patients Are Driving

According to recent data, 92% of U.S. consumers used digital payments for healthcare in 2024, and 73% prefer to pay bills online (source).

This trend is unmistakable: convenience is shaping consumer behavior across every industry, and healthcare is no exception. At PatientPay, we see this firsthand every day. Thousands of providers rely on us to deliver simple, app-free digital billing. No logins, no paper, no stress. That’s the kind of experience patients now expect, and why more healthcare organizations are making the switch every day.

Insurance and Health Savings Account (HSA) companies are listening. To meet this demand, they’re rolling out digital-first payment experiences through their own portals that make it easier for patients to pay for services.

Since launching PatientPay Accelerate™, we’ve heard from countless practices about what really happens behind the scenes with these payments. So we’re launching a short blog series to shine a light on this overlooked process:

• What’s good about insurance and HSA portal payments?

• What’s going wrong?

• Where are the hidden risks for revenue loss?

• And most importantly, how can practices avoid them?

Let’s start by breaking down what this payment flow actually looks like, and why it’s growing fast.

How It Works: Payments Through the Payer Portal

On the surface, it seems simple: a patient pays their medical bill directly through their insurance or HSA company’s portal. It’s quick, familiar (like paying a utility bill), and often part of the patient’s post-visit flow.

But here’s what’s happening behind the scenes:

• The payment is not going directly to the practice.
  Instead, it’s routed through an intermediary, typically a financial arm of the payer such as Optum Financial, which holds, processes, and eventually remits the funds to the provider.

• That payment may come as a paper check or virtual card based upon Provider choice.
  Either way, there’s a time lag, and the method is frequently disconnected from your EHR or billing system. That’s where things get messy.

• Reconciliation becomes manual.
  Staff must match incoming payments to patient records, often relying on vague payment memos or emailed remittance info. And when that info doesn’t show up? Payments sit in limbo.

Why It’s Growing

There’s no question that digital payments in healthcare are accelerating.

The U.S. digital healthcare payment market is expected to grow from $17.19 billion in 2025 to $94.15 billion by 2034, expanding at a compound annual growth rate (CAGR) of 21% (Precedence Research). That growth reflects both provider adoption and consumer demand.

We’re already seeing the shift in how payments are managed. In large U.S. health systems, 30% of all patient collections are now routed through portals (TechTarget). Insurance companies are responding by creating convenient pathways for patients to pay through their own platforms.

This is no longer a fringe channel, it’s quickly becoming a primary one.

The Pros

Why Patients Like It

For patients, paying through their insurance and HSA company’s portal can feel simple and secure. Digital wallets, embedded payment flows, and real-time confirmation provide the kind of trust and convenience they’re used to from other industries.

62% of surveyed patients say they prefer paying medical bills online (J.P. Morgan), reinforcing just how central digital-first experiences have become in patient financial engagement.

How Providers Benefit

From the provider’s standpoint, one of the biggest advantages is that they don’t have to bill the patient directly. The insurance company collects the funds, and a financial intermediary (e.g., Optum Financial) delivers the payment, typically in the form of a virtual card or a check.

This means fewer billing resources are required, and fewer statements are sent. But as we’ll explore in the next blog, not all delivery methods are created equal, and how those payments are received and processed makes all the difference.

The Cons: Where Practices Get Squeezed

While the payer portal model can streamline some patient collections, it’s far from perfect, and the pain often lands squarely on the provider.

Disconnected Payments:

Payments often arrive detached from the patient encounter or EHR. Billing teams must manually match deposits to services rendered, which slows down reconciliation and increases the risk of errors.

Check/Virtual Card Delays:

When payments are delivered via paper check, providers face unnecessary lag in cash flow. Funds can take days or even weeks to post, adding financial friction to a process that was supposed to be more efficient.  In addition, while the medical group is waiting for payment it is sending out bills to its patients.  This can create confusion with the patient since they have “paid” these bills but the medical group has not received payment yet.  

Virtual Card Costs and Manual Workflows:

Virtual cards, while faster than checks, introduce another layer of complexity. Card numbers must be processed manually, creating additional labor costs. Without automation, the burden shifts to already-stretched admin teams.

When Payments Fall Through the Cracks:

In the worst-case scenario, if a provider doesn’t process the payment, whether because the check sits uncashed or the virtual card isn’t keyed in, the intermediary (like Optum Financial) is required to refund the patient.
The result? Lost revenue, duplicate patient responsibility conversations, and a damaged patient experience.

What’s Next in the Series

This is just the beginning.

In the next few articles, we’ll take a closer look at the real costs hidden in the payment process, where practices commonly have issues, and how practices can take control.

If your organization is relying on the payer portal process to simplify payments, you might be missing out on payments, efficiency, and patient satisfaction. We’ll show you where the gaps are and how to close them.

Ready to Fix the Friction?

Explore PatientPay Accelerate, the purpose-built solution that helps healthcare practices get paid faster, more securely, and without the administrative mess that comes with patient payments via an insurance portal.

No more lost payments. No more staff burnout. Just money in your account, faster.