Payments have become one of the most complex and high-risk moments in the healthcare journey, impacting revenue, compliance, and patient trust all at once.
As EHR platforms have become central to healthcare operations, inefficiencies in payment processes are now more visible than ever and increasingly difficult to justify from both an operational and compliance standpoint.
Organizations need to rethink how payments are handled within and around the EHR – not as a standalone step, but as part of a secure, end-to-end workflow.
Healthcare pressure is exposing payment gaps
Across the sector, organizations are facing rising operating costs, workforce constraints, compliance pressures, and increasing expectations around the patient experience.
Revenue cycle efficiency has become critical. Delays in payment collection impact cash flow, while billing friction drives repeat calls, escalations, and administrative overhead. At the same time, manual reconciliation continues to consume time that already stretched healthcare teams simply do not have.
Security expectations are tightening too. PCI DSS 4.0 is now in full force, raising the bar for how payment data is handled, secured, and audited. HIPAA scrutiny is intensifying, and organizations are placing greater emphasis on vendor governance and resilience.
The US healthcare billing process also remains a significant point of friction for consumers, often characterized by a lack of transparency and high complexity.
While patients expect digital payment options and flexibility in how they pay, 40% of Americans still do not understand their most recent medical bill, meaning many prefer to speak with staff to understand what they owe and complete a payment.
The challenge is clear: healthcare organizations must modernize how payments are handled, without introducing compliance risk or losing the human support patients still rely on.
EHR systems centralize care – but payments often remain siloed
EHR platforms are the operational backbone for many healthcare organizations, with over 95% of hospitals in the US now using them to support clinical workflows, scheduling, and patient data at scale. However, they were not originally designed to manage payments as part of a seamless end-to-end process.
In many environments, payments still sit across multiple disconnected systems – from external portals to IVR and phone-based interactions – with transactions often initiated outside core EHR processes. This creates a fragmented revenue cycle that is harder to manage, with knock-on effects for both operational efficiency and compliance.
Staff are forced to switch between systems just to complete a single transaction, while account balance updates are not always aligned or up to date. Over time, this increases administrative effort, slows reconciliation, and raises the overall cost to collect.
It also makes compliance harder to control. When cardholder data is heard, seen, or handled across multiple touchpoints, more of the environment can fall into PCI DSS scope – driving up audit complexity, cost, and risk. Even when parts of the process are secure, gaps can still exist elsewhere.
In many organizations, a single payment interaction can unintentionally expand PCI scope far beyond what teams expect.
Closing the gap around healthcare payments
To address these challenges, payments can no longer sit outside core workflows. They need to integrate with the platforms healthcare teams already rely on – without adding complexity or expanding compliance risk.
This means enabling payments to be handled within existing processes across billing, registration, and post-visit interactions, as well as across every channel, from phone-based interactions to digital and self-service.
This also requires a PCI DSS-focused approach, ensuring sensitive cardholder data is not exposed to internal systems, call recordings, or agent desktops, helping reduce PCI scope and support compliance efforts.
PCI Pal: secure payments for Epic workflows
This is where PCI Pal comes in, enabling healthcare organizations to initiate secure, PCI DSS-compliant payments directly within their EHR, including platforms such as Epic, so payments can be handled where care and billing already take place.
Within Epic workflows, staff can initiate payments across billing, registration, and post-visit interactions in a single click, with payment status and account balance updates written back into Epic in real time.
Patients also benefit from greater choice in how they pay, whether via voice, keypad, or digital link, using cards, ACH, or digital wallets across both assisted and automated interactions.
From a security and compliance perspective, PCI Pal’s cloud platform ensures that sensitive cardholder data is kept outside of Epic and not exposed to agents or internal systems. This helps healthcare organizations reduce PCI scope across their teams and systems, lowering audit effort, cost, and risk.
Importantly, PCI Pal only processes the specific patient data the healthcare organization chooses to send. Data access is always limited, controlled, and purpose-driven.
What this means for patients and hospital teams
For patients, the experience becomes simpler and more flexible. Payments can be completed through the channel and method that suits them, which is essential, as nearly 50% of consumers would consider switching providers after a poor payment experience.
For hospital teams, this reduces friction across the revenue cycle. Payment status and confirmation details are written back into Epic, giving teams a single, reliable view of patient payments, along with improved accuracy and faster reconciliation.
By aligning payments more closely with how care and billing already happen, organizations gain greater control and consistency across the revenue cycle.
Secure every patient payment
Healthcare organizations can no longer afford payment processes that sit outside the systems they rely on most.
By integrating secure, PCI-compliant payments into EHR workflows, organizations can simplify operations, reduce compliance risk, and deliver a more consistent payment experience across every channel.
With PCI Pal, healthcare organizations can:
- Simplify their approach to payment security and compliance
- Deliver a more flexible, accessible payment experience
- Accelerate collections while reducing operational friction
Ready to bridge the gap?
See how PCI Pal supports secure, compliant payments across your EHR and patient engagement workflows.
