Most patients have received texts asking them to confirm or cancel a doctor’s appointment. But what about a text alerting them that out-of-pocket costs for an upcoming MRI exceed $500?

“The most common way health systems are using text messages today is for automated appointment reminder texts,” notes Samantha Wyld, a partner at Eden Prairie, MN-based Optum Advisory Services.

Would receiving texts on out-of-pocket costs be annoying or helpful? It probably depends on the amount the person owes. Here, patient preferences must be weighed carefully.

“Organizations should poll their patients to understand their cost thresholds,” Wyld says. Patients may accept not knowing in advance if their out-of-pocket costs are going to be less than $100. “But if they owe between $100 to $500, maybe they’d prefer to receive a text or email notification before service,” Wyld offers. If the amount exceeds $500, most people would want a more in-depth discussion on the specifics and payment options.

Wyld says that texts should provide the scheduled date of the upcoming service and state the patient’s expected out-of-pocket cost, specify that the amount is an estimate and may change, and instruct the patient how to pay his or her estimated obligation.

The text can invite patients to reply their own text expressing a desire to pay if they have a credit card on file with the organization. The text could contain an embedded link the patient can click on to pay. Texts to patients also should provide the phone number of who or what department to contact if the patient wants to ask questions. Also, if the organization offers a prompt pay discount, the text could mention language such as, “That, of course, would need to be run through compliance.”

When it comes to patients’ financial experience, says Wyld, “overwhelmingly, patients’ primary desire is to avoid the dreaded surprise bill that they didn’t see coming and aren’t sure how they’re going to pay.”

For patient access, this means finding better ways to tell patients the cost of their care earlier in the process. Since patient access departments need to do so without adding full-time employees, texts, emails, and patient portals are the likely answer.

“This moves health systems away from manual, costly, and increasingly ineffective phone calls to patients,” Wyld says.