A text comes in from my provider with a link to pay my balance. I'm blind, so I navigate the web with a screen reader, and within about thirty seconds of tapping that link I already know this is going to be a fight.
Whether the bill arrives by text, email, patient portal, or a QR code on a paper statement, paying it online has become almost unavoidable for me. The trouble usually starts well before I reach the payment screen.
Reviewing the Bill
Before I get to the payment screen, I'm usually given a chance to review the invoice. It lists dates of service, insurance contributions, the type of care provided, and the balance I owe. I want to read through all of it carefully before I hand over my card.
The information is laid out in a table. My screen reader struggles to move through it in order when the table isn't coded with proper row and column headers. I lose track of which charge belongs to which date.
Healthcare bills confuse me, especially the insurance contributions and how they affect what I owe. Many bill pay screens include little icon buttons that open a tooltip with more detail about a line item. Sometimes those buttons aren't labeled, so my screen reader skips right past them. Other times the tooltip opens but I can't find a way to close it and get back to the main page.
Some statements show charges, credits, and insurance contributions with "+" and "-" symbols in front of the dollar amounts. My screen reader ignores those symbols completely. I have no way to tell what's coming in and what's going out, and the final total stops making sense to me.
Entering My Card
Most healthcare bills I pay come down to entering a credit or debit card. The card entry screen is where things fall apart for me.
I have to fill out several text fields, both for the card itself and for my name and billing address. When those fields aren't labeled, I'm guessing where each piece of information is supposed to go.
The payment network selectors are another problem. Visa, Mastercard, and the rest are shown as small icons of the company logo. Without code-based labels, my screen reader just says "image" or "button," and I have no idea which one I'm picking.
Expiration date entry can also break down. Sometimes the cursor doesn't move to the year field after I type the two digit month. On mobile, the drop-down menus or scroll-wheel pickers close before I reach the value I need and bounce focus back to the top of the page. With a newer card that has an expiration year well into the future, the picker takes longer to navigate, and I sometimes give up.
Confirming the Payment
Submitting the payment is one thing. Knowing it actually went through is just as important to me, and the confirmation page is where I run into a different set of problems.
My screen reader will sometimes announce "Your confirmation number is:" and then go silent. Other times it reads out "null" or some other meaningless term. Moving around the page doesn't give me anything else to work with.
I think the number is being placed in some kind of inaccessible text box meant to catch the eye of a sighted user. Being unable to copy that number is frustrating, especially when no email confirmation shows up afterward. If the payment didn't actually process, I won't know until a late notice arrives or the balance gets sent to collections, and I'll have nothing on my end to point to.
On other confirmation pages, the buttons to end the session or return to the patient portal aren't labeled. The only thing I can do is close the browser tab and hope the payment landed.
Where That Leaves Me
Digital payment is now the main way I settle healthcare bills, and the gaps in these interfaces leave me dependent on phone calls and sighted help to handle something my providers expect me to do on my own. Independence over my own health includes the boring parts: paying the bill, knowing it went through, and not having to ask someone else to confirm it for me.
FAQ
Do you ever just call the billing department instead?
Sometimes. When the online flow falls apart at the confirmation page, picking up the phone is the only way I trust the payment actually went through.
Which part of the process gives you the most trouble?
The card entry screen. Unlabeled fields and icon-only network selectors are where I get stuck the most.
Have you found any bill pay systems that work well?
A few. The ones that work share the same basics: labeled fields, properly coded tables, and a confirmation page I can actually read.
Why doesn't an email confirmation solve the problem?
It would, but I don't always get one. If the number on screen is unreadable and no email arrives, I have nothing to reference if there's a billing dispute later.
This is a guest post from our marketing contributor, Michael Taylor. It reflects his opinions and experiences. Read more about Michael and some other posts on his experience online here.
