How Cedar’s real-time integration available on Epic Connection Hub is changing the patient financial experience

For many patients, a routine checkup, an emergency visit, or a procedure is only one half of their healthcare journey.  The other half starts when the bill arrives.  

As patients take on more of the cost of care, they need help understanding what they owe and deciding what to do next. Health systems want to help them—and getting it right often matters just as much to patients as the care they’ve received. Cedar helps health systems do just that, with a platform that brings billing, payments, coverage, and support together so that patients receive a plain-language bill with a current balance and information explaining what they can do about it—from a payment plan to financial assistance to an explanation of their insurance benefits.  

Integration with electronic health record systems (EHRs) like Epic make that possible. Cedar receives information about each patient’s current balance, presents the patient with a bill that contains the information they need to understand their options, and sends patient payment postings back to the health system through the EHR. Over the past year, Cedar has participated in Epic’s Vendor Services developer program to improve that connection for the patients and health systems. 

_{Getting the Right Information to the Right Patients at the Right Time}

No two patients are in the same financial position. A patient with insurance and a modest copay might only need a quick explanation or a simple way to pay their bill. A self-pay patient with a large balance after a long hospital stay might need flexible payment options or help understanding the bill. Meanwhile, health systems want to know which patients to reach, when, and how, so they can make sure each one has the help they need. 

According to Cedar’s 2026 Healthcare Financial Experience Study, 50% of patients have reported they’ve used AI tools to interpret a bill or resolve a billing problem. Many others don’t seek help at all: four in ten say they don’t reach out when a bill is confusing.  

That makes it important for health systems to reach patients first, with outreach that reflects where each patient is today. As the study notes, a patient’s situation can change quickly. A new insurance plan or a change in finances can shift what someone needs from one bill to the next.

The study suggests that outreach works best when it comes with help that fits the patient’s situation. That might be an affordable payment plan, help finding financial assistance or coverage, or a clear explanation of what their insurance covered. When a reminder comes with a clear path forward, patients are better positioned to act on it.

Doing that depends on knowing where a patient’s balance stands. Batch-based file exchange, which updates records on a set schedule, is reliable and works well for many tasks, including when a payment posts and changes the patient’s balance.  API exchanges allow real-time integration, letting Cedar share changes to patient’s balances in real time.

"API integrations play a critical role in enabling timely, accurate data exchange between systems, ensuring patients have access to the most current information regarding their financial responsibilities,” said Tony Morrison, VP, Chief Revenue Cycle Officer at Sanford Health. “When these integrations are not in place, delays in information updates can occur, creating unnecessary friction and potentially impacting the patient experience and delays in payment. Greater collaboration across the healthcare technology ecosystem, with a shared focus on the patient, would help facilitate more seamless, real-time information exchange through API connectivity."

_{How Integration with Epic Leads to a Clearer Bill}

Cedar is one of the Billing Portal apps listed on Epic Connection Hub, an online directory where health systems find products and services that work with Epic. Cedar’s integration connects directly to the provider’s Epic instance, and the exchange of information between the health system and Cedar move through that connection.  

When a patient should receive a bill for a service or procedure, their current balance moves from the health system to Cedar through a balance pull API from Epic. Cedar uses it to prepare the bill the patient receives, so what they see reflects where their account stands right now. When the patient pays, the payment posting goes back to the health system’s Epic system using APIs, so the patient’s records stay current. Because the connection runs through APIs, updates arrive right away instead of on the next scheduled batch. 

Because the two systems stay in sync, patients get a consistent experience no matter which system they’re using.  The health system keeps control of its policies, workflows, patient relationships, and operational priorities. 

Each setup is tailored to the health system. When a health system or specialty practice brings on Cedar, Cedar’s implementation team works with its IT staff, and with Epic as needed, to fit the integration to the organization’s systems and workflows.

“Cedar’s integration enables a seamless patient experience in the manner that is the most effective for communication and payment.  We have experienced improved digital engagement across our population since deploying Cedar and it has raised the digital literacy of our market,” said Bill Gress, Director, Revenue Cycle Operations at Cottage Health. “Establishing an API-based payment posting integration ensures this consistent patient experience and helps avoid labor-intensive payment reconciliation rework for our team."

For health systems , making this work takes clear ownership, reliable data exchange, and a shared commitment to the patient experience. 

"Improving the patient financial experience while protecting our financial sustainability is a problem that requires partners, not point solutions,” said Dr. David Jevesevar, CEO, OrthoVirginia. “We appreciate that Cedar and Epic have collaborated so that a robust integration adds real, incremental value—strengthening our Epic investment and always preserving the experience our patients deserve."