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When you evaluate an AI agent for your patient billing call center, you need to know which work it takes over. A patient asking for a payment link and a patient disputing a charge may call the same number. The agent needs an approved next step for each.
Hello Patient builds AI agents for healthcare. Our agents explain outstanding balances, send secure payment links, offer configured payment plans and run outbound collections.
What work can move from a patient billing call center to an agent?
The agent can handle balance questions, requests for payment links and conversations about the payment terms your practice has approved.
Start with the requests you want it to handle. The table below is a proposed evaluation aid, and the examples in this guide are illustrative. Your billing team should review the actions and owners before using them.
| Patient request | Enabled agent action | Evidence to check or human owner |
|---|---|---|
| Explain an outstanding balance | Identify the patient and explain the balance from the configured account source | Correct account, current balance and an explanation supported by available information |
| Send a secure payment link | Send the link for the approved payment provider | Link delivery; check posted payment separately |
| Discuss a payment plan | Offer the plan terms configured by the practice | Terms offered; enrollment and first payment checked separately |
| Dispute a balance | Capture the concern and route it | Billing staff review the account, starting from the concern the agent captured |
| Ask for hardship help | Capture the request for your practice's decision | Named billing team or assistance contact |
| Report a failed payment | Capture the problem and route it | Billing staff check the payment status, starting from the problem the agent captured |
Which billing conversations can the agent finish?
A balance question can finish when the identified patient gets an explanation supported by the account information available to the agent. A request for a payment link can finish when the correct link reaches the patient.
For example, a patient asks for a link, receives it and ends the call. Record that as a delivered link. Check the payment system separately for a completed payment, including when it posts. Name the person or system responsible for confirming that result during the evaluation.
Our agents can look up balances by voice and SMS after the configured identification process. Patients enter payment details through a secure link. The patient billing line guide covers the conversation mechanics in more detail.
How should outbound follow-up work alongside the billing line?
Outbound follow-up should use the same approved balance information, payment terms and escalation rules as inbound conversations. Our agents can contact patients by voice and text. The evaluation needs to cover what happens when a patient replies, as well as the initial message.
A reply such as “I already paid this” tests how account information reaches the conversation. Your practice decides who checks the payment and which outreach rule applies before another reminder goes out.
Our billing follow-up guide covers that work in more detail. You can also hear our agents before discussing which billing conversations to include in an evaluation.
Who decides on disputes and hardship requests?
Your practice chooses who receives disputes, hardship requests and payment failures, and that person starts from what the patient told the agent. The agent explains the outstanding balance and offers approved terms.
“What do I owe?” becomes “That visit should have been covered.” The agent recognizes the new request and passes it on, so the account review starts from the patient's own words. Your team should approve that transition before launch.
What must survive the transfer or ticket?
The receiving biller needs enough context to act. During evaluation, check that the transfer or ticket carries the patient's request, the relevant account, what the agent explained or offered, and what remains unresolved. Your team should be able to find the open question without reconstructing the conversation.
Live transfers are available on voice calls. Written conversations route through a ticket, email or message. After-hours destinations and fallback routes follow your practice's configuration, so test what happens when the intended person is unavailable.
With an outsourced center, agree who owns each open request and which account information both teams use. HFMA's consensus guidance supports provider-approved policies, access to relevant account data, regular reconciliation between provider and affiliate systems, and visibility into patient complaints. Use it to help assign responsibilities. Read HFMA's medical-account resolution guidance.
How should you assess the rollout?
Assess the rollout against the requests you agreed the agent would handle. Use de-identified examples from your own billing work, and have your billing team review both completed conversations and escalations.
For each test, check whether the agent used the right account information, took the approved action and left evidence of the result. Track answered calls, delivered links, plan offers and posted payments separately. Also check whether open requests reached the responsible person and what that person had to do next.
We’re HIPAA-compliant and sign a BAA. Our patient-data and security guide covers those questions separately from the workflow evaluation.
Schedule a billing-workflow evaluation with us. Bring de-identified requests and your team's escalation requirements. We'll use them to scope the conversations, data access and payment setup to evaluate.
Frequently asked questions
Can we introduce an AI billing agent while keeping our outsourced call center?
Yes. You can scope a Hello Patient agent around selected conversations while keeping the outsourced center responsible for the remaining work. Agree on that division before routing calls. For example, your evaluation might cover balance explanations and payment-link requests while the outsourced team keeps disputes and hardship cases. Confirm who owns an unresolved request, where it is recorded and how both teams learn that a payment or account change has occurred. Review the arrangement with the provider so the agent's work and the center's responsibilities are clear to everyone handling the account.
What should we test before routing a statement-day rush to an AI agent?
Test the expected mix of calls and the volume you plan to route. For a Hello Patient evaluation, include balance questions, payment-link requests, payment-plan conversations and requests that change into disputes. These are illustrative test cases; add examples from your own billing line. Check what happens when one of your systems or a transfer destination is unavailable. Then inspect the records left for your team and count answered calls, delivered links, plan offers and posted payments separately.
What happens if a patient cannot use a texted payment link?
The next step should follow the alternative payment process your billing team approves. Your practice chooses who helps, and that person starts with the details Hello Patient's agent collected. During setup, include cases where the patient cannot receive texts, cannot open the link or needs assistance using the payment page. Confirm the destination during staffed hours and the fallback after hours. Record that payment help is still needed so a sent link is not mistaken for a completed payment or a resolved request.
Can a billing agent handle locations with different payment systems?
Your practice sets up each location on its own. For Hello Patient, confirm each location's account data source, payment-link provider, approved plan terms and billing destination before deciding which conversations to enable. Include an illustrative case where a patient has accounts at two locations, and check that the agent selects the correct account and link. Confirm the account checks and staff destinations for each location, then use the test results to agree on its rollout scope.
How should we count the payment plans an AI agent offers?
Count a plan as active when your payment system shows the enrollment and the first payment. Hello Patient's agents offer the payment-plan terms your practice configures. If a patient says a monthly amount works for them, record the terms offered and any follow-up needed, then check what happens next in the payment system. Your evaluation should establish where each result is recorded. Track plan offers and posted payments as separate results, so your plan count matches your payment records.
Should outbound billing outreach continue while a balance is disputed?
Further outreach should follow your practice's approved dispute policy. When a patient disputes a balance, Hello Patient's agent passes the dispute to the person your practice chooses. Your outbound reminders should follow the same escalation rules as inbound conversations. In a Hello Patient evaluation, establish who marks the account for review, how that status reaches the outreach process and who authorizes the next contact. Then test a dispute raised by an inbound call while an outbound reminder is already scheduled.
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