Emmett Bernsohn
Founded in 1978, Choptank Community Health is a private, non-profit FQHC serving more than 30,000 patients across five counties on Maryland’s rural Eastern Shore — medical, dental, and behavioral health, open to everyone regardless of ability to pay. Patient payment had always been a pressure point. Rivia Health changed that.
The Challenge
FQHCs run on tight margins, servicing patient populations that often have complex financial situations. For Choptank Community Health, patient payment was a constant pressure point. Before Rivia Health, the average patient balance sat in accounts receivable for 75 days. Small balances and aged receivables were regularly written off or abandoned — revenue that simply disappeared. The billing team spent their days on manual work: printing statements, fielding calls, entering payment plans, posting payments by hand.
The Solution
Choptank deployed Rivia Health’s full patient payment automation suite, integrated directly with their athenahealth EHR.
The platform handles the entire patient payment workflow — billing communications, digital payment options, payment plan creation, and real-time payment posting — with no manual work required from staff. Patients receive outreach through text, email, and other digital channels, on their terms.
Of 99,142 automated communications sent, only 19 patients unsubscribed.
They don’t find the outreach intrusive. They act on it.
The Results
FROM 75 DAYS DOWN TO JUST 27 DAYS
The biggest shift was speed. Patient balances that previously sat in AR for an average of 75 days are now paid in 27. That’s 48 days sooner — nearly seven weeks of cash flow available to the organization sooner. For an FQHC operating on thin margins, that’s not a small thing. Faster payment means more stability. More stability means more capacity to focus on what the organization actually exists to do.
2X ROI ON AGED AND SMALL BALANCES
What qualifies as “aged and small-balance” collections? Transactions where the amount paid was under $9.99 and/or the balance had been sitting in AR for more than 89 days at the time of payment. These are the balances that typically fall through the cracks in a manual workflow — too small to justify staff time or too old to expect recovery.
37% of all payments through Rivia Health came from transactions under $9.99 or balances that had been sitting in AR for more than 89 days. That’s more than one in three dollars — from accounts that, in a manual workflow, typically don’t get paid. Measured against the cost of the Rivia Health platform, those aged and small-balance recoveries alone deliver a 2X return. That doesn’t include the 63% from current balances, the time savings, or the reduction in AR days.
AUTOMATION AT SCALE: ZERO MANUAL EFFORT
The numbers tell the story:
- 99,142: Patient billing communications sent automatically — no manual work required
- 58: Payment plans created automatically — no manual data entry required
- 995: Payments collected and posted back into Athena Health in real time, automatically
- .02%: Patients unsubscribed – 19 in total
The near-zero unsubscribe rate is especially meaningful in an FQHC setting. It demonstrates that even in a patient population that may have complex financial situations, patients welcome the digital payment reminders and find the process accessible and helpful rather than burdensome.
HOURS, AND HOURS OF STAFF TIME SAVED
Each automated transaction saves the billing team an estimated 5–10 minutes of manual work — payment plan setup, payment posting, patient follow-up.
Across 995 transactions over 12 months:
- Conservative (5 min/transaction): 83 hours saved over 12 months
- High estimate (10 min/transaction): 166 hours saved over 12 months
That only counts the payment transactions. The 99,142 automated communications represent an additional volume of patient outreach that the team no longer had to manage by hand.
Built For FQHCS
- Patients act when the experience works for them. Multi-channel digital outreach — text, email, digital payment links — meets patients where they are. A 0.02% unsubscribe rate across a diverse, often financially complex patient population says something important: the experience felt helpful, not like pressure.
- Cash flow is the mission. Getting paid 48 days sooner per balance isn’t just an operational efficiency. For an FQHC, it’s what makes continued service possible.
- Aged and small balances are worth pursuing. 37% of Choptank’s payments came from accounts that historically would have been written off. That’s significant revenue — now within reach, without additional staff effort.
- The team gets time back. 99,142 communications sent, 58 payment plans created, 995 payments posted — all without manual work. That’s time and bandwidth returned to patient care.
- The EHR stays accurate. Every payment posts back into athenahealth in real time. No manual entry. No reconciliation gap.
The ROI is Real
Taken together, the results represent what’s possible when patient payment runs on its own — and the team’s time goes back to patient care.
- 2X ROI: On aged (>89 days) and small-balance (<$9.99) payments alone — 37% of all payments recovered from 359 transactions that would likely have been lost
- Collection Speed: 64% faster — average days to payment reduced from 75 to 27 days
- Automation: 99,142 communications, 58 payment plans, 995 payments posted — all with zero manual effort
- Time Savings: 83–166 hours of staff time saved on payment transactions alone
- Patient Engagement: 99.98% of patients stayed subscribed to billing communications
Rivia Health brings easeful efficiency to healthcare patient payments. We work with healthcare providers to streamline revenue cycle operations through our intelligent communication and payment platform. By automating workflows for appointment reminders, billing notifications, and payment plans, Rivia Health reduces time spent on billing, captures lost revenue, while providing both provider and patient support. Our patient-first solutions make it easier for patients to pay medical bills with a frictionless 3-step process. Rivia Health complements existing systems so healthcare providers are paid faster, and easier.
