Startups Bring Digital Payments Into Complex Healthcare Billing

When patients step into a doctor’s office, they expect care, not confusion. Yet for millions of Americans, the patient journey doesn’t end with diagnosis. It derails at the payment level.

The latest PYMNTS Intelligence from the June 2025 PYMNTS Data Books report, “Clicks, Care & Copays—How Each Generation Navigates Digital Healthcare,” finds that, despite being digital natives, younger generations are technologically struggling to make basic healthcare payments.

And this, after all, is a generational cohort for whom roughly 1 in 3 reported that their most recent healthcare experience was a virtual or digital one.

But between opaque pricing, fragmented systems, and clunky user experiences, the financial side of healthcare is often a labyrinth of inefficiency. The result can be frequently missed payments, frustrated patients and untold sums in potentially uncollected revenue.

But PYMNTS Intelligence also reveals that a wave of innovation is changing the sector’s historic bottlenecks around revenue cycle management (RCM) and having an upstream impact on the ways in which patients pay for care and build financial relationships with their provider networks and systems.

FinTech startups and healthcare platforms are turning to embedded finance, particularly payment orchestration, in-app billing, and intelligent reminders; to reimagine how patients pay for care. The goal isn’t just efficiency. It’s empathy. And it may hold one key to unlocking sustainable growth in a sector long stymied by complexity.

Embedded Finance Meets Embedded Care

In most industries, the idea that a customer wouldn’t know what they owe, or how to pay, would be considered a failure of design. But in healthcare, that’s the norm.

Across all generations surveyed in the report, payments friction was the one issue that emerged as a nearly universal concern. Whether it’s the lack of price transparency, the unpredictability of insurance coverage, or the hassle of copays, patients of all ages expressed frustration with the financial layer of healthcare.

The pain is felt on both sides. Providers can struggle with high collection costs, delayed payments, and rising write-offs. Meanwhile, payers and platforms are caught in the middle, navigating an increasingly complex regulatory and technological landscape.

The opportunity, therefore, is to build payment experiences that mirror the best of consumer tech: seamless, intuitive and personalized.

Embedded finance, which is the integration of financial services directly into non-financial platforms, is hardly a new concept. Ridesharing apps process payments without breaking flow, and eCommerce sites offer one-click buy now, pay later. The secret sauce? APIs, orchestration layers, and real-time decisioning engines working behind the scenes.

Read the report: Clicks, Care & Copays—How Each Generation Navigates Digital Healthcare

Payment Orchestration as the Backbone of Better Billing

Startups like Cedar, Hint Health and PayZen are pioneering platforms that integrate billing directly into the patient experience, often through white-labeled interfaces or APIs. These platforms orchestrate multiple payment rails — credit cards, HSAs, digital wallets, financing options — within a single, intuitive user flow.

The result is a system where patients receive estimates up front, choose how they want to pay, and get reminders tailored to their behavior. It’s not just about digitizing the bill. It’s about rethinking the billing moment entirely.

At the heart of this transformation lies payment orchestration: the practice of routing transactions through multiple providers and rails to optimize cost, success rates and user experience.

Think of it as air traffic control for healthcare payments. Instead of relying on a single processor, platforms can dynamically choose between multiple gateways, offer real-time financing options, and adapt payment flows to user preferences.

Moreover, embedded billing creates a data loop that benefits everyone. Platforms can analyze payment behaviors, identify bottlenecks and continuously optimize experiences. Providers gain visibility into revenue trends. Patients get more transparency and control.

It can be a virtuous cycle, but only when designed correctly.