Patient Estimates and Pre-Payment

Collect before you treat

Manta Health's Patient Estimates and Pre-Payment pillar calculates accurate patient cost estimates from verified benefit data and collects payment before treatment, so your practice gets paid and your patients have no financial surprises.

IMMEDIATE RETURN ON INVESTMENT

What's billing after the claim costing you?

Adjust the numbers below to see what it's worth for your practice.

Patient volume (per month)

Average patient responsibility

Copay + deductible + coinsurance owed per visit, on average.

Bills that go unpaid30%

0%industry avg ~50%+60%

Days for patients to pay (billed after claim)60 days

060120

▸ Refine the estimate (optional)

Already collected at point of service today10%

Many practices already collect copays up front. Set this to the share of patient responsibility you already capture before the patient leaves — the model only applies the numbers above to what's left over.

Cost of billing after the claim

Never collected (bad debt)

Cash tied up in AR (60-day float)

What is patient financial clearance?

The fourth step in the Coverage Intelligence workflow

Patient financial clearance is the process of calculating what a patient owes, communicating that amount clearly, and collecting payment before care is delivered. Manta automates both sides: estimate generation from verified eligibility data and fee schedules, and pre-payment collection via a patient-facing portal that requires no account creation and works on any device.

Patient financial clearance is the final step in the Coverage Intelligence workflow. Eligibility verification provides the benefit data. Prior authorization secures payer approval. Estimates and Pre-Payment uses both to calculate what the patient actually owes and collect that amount before treatment. Learn more about Patient Financial Clearance →

How It Works

How Manta calculates patient estimates

Practices load their own cash and insurance fee schedules into Manta. The pricing engine resolves the most specific applicable rate per CPT code and surfaces a confidence tier on every estimate so staff know how reliable the calculation is before sending it to the patient.

SELF-PAY PATIENTS

Good Faith Estimate

For self-pay and uninsured patients, Manta generates a Good Faith Estimate using the practice's loaded cash fee schedule. Staff selects the patient, provider, location, service date, and CPT line items, or the form pre-fills from a linked treatment. The pricing engine runs each line against the cash fee schedule and produces a per-line and total patient responsibility. The output is a finalized, immutable PDF with pinned disclaimer versions aligned to No Surprises Act requirements.

INSURED PATIENTS

Insurance Estimate

For insured patients, Manta resolves the allowed amount per CPT code from the practice's insurance fee schedules, then applies the patient's verified benefit data: deductible remaining, coinsurance rate, copay, and out-of-pocket maximum, to calculate patient responsibility line by line. Benefits come from the verified eligibility check or, where needed, from manually entered benefit details. Each estimate carries a confidence tier: Best, Better, Good, or None, so staff know how reliable the calculation is before sending it to the patient.

DELIVERY

Estimate Delivery

The finalized estimate is delivered to the patient by email and SMS via a branded, secure link. The patient lands on an identity-verified portal with no account required, where they can view the full cost breakdown, download the PDF, and pay directly.

Benefit Summary

What the estimate includes

For each patient estimate, Manta produces:

Practice name, provider name, NPI, and location

Patient name and date of birth

Service date and CPT line items with descriptions and quantities

Allowed amount per line

Insurance responsibility per line for insured patients

Patient responsibility per line and total

Deductible applied, coinsurance, and copay breakdown

Out-of-pocket maximum applied where relevant

Confidence tier indicating estimate reliability

Pinned disclaimer version aligned to No Surprises Act requirements

Pay Now link when a payment request is attached

Pre-Payment Collection

From estimate to payment in one workflow

Patient side:
When an estimate is finalized, a secure practice-branded pay link is generated and sent to the patient by email and SMS. The patient opens the identity-verified portal, reviews their cost breakdown, and pays. The checkout is hosted by Manta's integrated payments processor — card data never touches Manta's backend, keeping the practice in PCI SAQ A scope. Accepted methods include card, ACH bank transfer, tap and swipe in-person, and phone collection. If payment is not made, an automated SMS reminder fires. Staff can also collect in-person or create a standalone payment request without an estimate.

Staff side:
Every estimate and payment is tracked in one place. The Estimates page lists all estimates filterable by status, type, date, and patient, with actions to finalize, share, void, download, and regenerate pay links. The Payments page shows the full lifecycle across pending, paid, failed, overdue, refunded, and cancelled. The Deposits and Reconciliation Dashboard shows gross collected, processor fees, and net deposit per batch with per-deposit drill-down.

Coverage Intelligence

Where estimates and pre-payment fit in Coverage Intelligence

Patient financial clearance completes the Coverage Intelligence workflow. By the time a payment request reaches the patient, the payer side has already been resolved: coverage verified, authorization secured, and any denial appealed. The estimate is built on real benefit data, not assumptions.

Patients who pay before treatment are significantly less likely to cancel or no-show. Practices that collect upfront remove the need for post-treatment statement cycles, collection calls, and write-offs.

Eligibility

Eligibility and Coverage Verification

Manta verifies active coverage, interprets benefit details by treatment and CPT code, and confirms whether prior authorization is required before care is delivered.

Learn more →

prior authorization

Prior Authorization

Eligibility determines whether authorization is required. Manta prepares and submits documentation automatically for any payer.

Learn more →

previous step

Agentic AI Appeals

Every denial auto-appealed immediately upon receipt. Payer-specific AI drives a 90%+ overturn rate.

Learn more →

Frequently Asked Questions

Common questions about Patient Estimates and Pre-Payment

What is a Good Faith Estimate?

A Good Faith Estimate is a written cost estimate provided to uninsured and self-pay patients before scheduled services. Under the No Surprises Act, healthcare providers are required to provide GFEs upon request or when a service is scheduled. Manta generates GFEs automatically from the practice's cash fee schedule, producing a finalized PDF with the required fields and pinned disclaimer language.

How does Manta calculate patient responsibility for insured patients?

Manta resolves the allowed amount per CPT code from the practice's insurance fee schedules, then applies the patient's verified benefit data, including deductible remaining, coinsurance rate, copay, and out-of-pocket maximum, to calculate patient responsibility line by line. Benefits are sourced from the verified eligibility check where available, or from manually entered benefit details as a fallback.

What is the confidence tier on a patient estimate?

The confidence tier reflects how specific the rate match was in the fee schedule resolution. Best indicates an exact match on payer, plan, location, and CPT code. Lower tiers indicate the engine fell back to a broader match. Staff can see the confidence tier before sending an estimate to the patient.

How does the patient receive and pay their estimate?

The patient receives a branded email and SMS with a secure link. Clicking the link opens an identity-verified patient portal — no account required — where they can view the full cost breakdown, download the PDF, and pay. Accepted payment methods include card, ACH bank transfer, tap and swipe, and phone collection.

Is card data stored in Manta?

No. The payment checkout is hosted by Manta's integrated payments processor. Card data never touches Manta's backend, keeping the practice in PCI SAQ A compliance scope.

How does pre-payment collection reduce cancellations?

Patients who make a financial commitment before their appointment are significantly less likely to cancel or no-show. Manta targets up to 25% fewer preventable cancellations by converting scheduled visits into collected commitments before the date of service.

What happens to patient balances after pre-payment?

For visits where pre-payment is collected, downstream collections risk is removed. Manta's pre-payment model is designed to eliminate the post-treatment statement cycle and collections overhead for pre-paid visits.

Does Manta integrate with existing EHR and practice management systems?

Yes. Manta integrates with the practice's EHR and practice management system to read scheduling, patient, and insurance data and write payment and estimate status back. Current integrations include leading ambulatory EHR and practice management platforms, with additional connectors available through Manta's integration framework.

Ready to collect before you treat?

Manta Health automates patient cost estimation and pre-payment collection for specialty procedural practices, so your team spends less time chasing balances and more time delivering care.

Book Your Demo Today

Ready to Transform Your RCM Process?

Say goodbye to faxes, lengthy phone calls, and tedious RCM admin.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form.