From Charge-Off risk to 45-50% Resolved : A Medical Credit Card AI Debt Collection Turnaround

How Skit.ai turned an unworkable medical credit card portfolio into 98% account coverage with an empathy-first, multichannel approach.

The Company

This Virginia based medical financing company provides credit cards designed for healthcare expenses. Their products help patients cover costs for surgery, treatment, and ongoing care, offering credit lines that keep borrowers protected for medical emergencies. At a time when unexpected medical bills can derail a household’s finances, this medical financing company bridges the gap between what insurance covers and what patients owe.

Problem Statement

This medical financing company needed a dedicated collections engine to support its growing medical financing portfolio. The company did not have deep in-house expertise in structured collections, settlement frameworks, or multi-channel debt collection management. After evaluating multiple vendors across the Al debt collection and automated collections software landscape including several debt collection management partners and collection systems brands, Lane Health selected Skit.ai for its flexibility, commercial experience, and proven ability to operationalise Al for debt collections end-to-end.

Context Building: Understanding the Medical Borrowers

Why do they miss payments?

• In a mid-treatment or post-surgery: Many borrowers were still in a cycle of medical care and could not prioritise repayment.
• Figuring out total expenses: Medical bills arrive in stages. Borrowers did not always know their full financial picture yet.
• No prior contact: Many accounts in the 0 to 30 DPD bucket had likely never been reached out to before.
• HIPAA limitations: Collections teams operate without access to patient health history, making context-building harder.

What the data showed?

Behaviour	Insight
Borrower Intent	The borrowers had good intention to pay. Patients understood that this company helped them and were willing to pay once recovered. It was just the time period problem they were struggling to pay back.
Payment Pattern	Concentrated in the first week and end of month, aligned with their paycheck cycles.
Channel Preference	Email as verified source allowed account detail sharing. Pre-nudge emails drove strong self-resolution.
Sensitivity	Medical portfolio requires subtle, non-pushy messaging. Consequences-based messaging was not appropriate for this kind of portfolio.
Post-Charge-Off Gap	The organization lacked a formal framework for settlements and possessed no prior internal expertise in managing structured settlement processes.

Every insight became a campaign decision

What We Learned	What We Changed
Borrowers had good intent but were mid-treatment	Built empathy-first messaging. Calls focused on incentives (continued card access, future protection) rather than consequences
0-30 DPD accounts had likely never been contacted	Deployed a digital nudge strategy with a pre-nudge email notifying borrowers of an upcoming call, with a payment link. Most resolved without human contact.
Cured patients felt gratitude towards the company	Leveraged goodwill in pre-charge-off outreach. Positioned the company as a partner in their care, encouraging payment to maintain the relationship and credit access.
The Client had no settlement framework	Skit.ai designed a tiered settlement grid with a 40% settlement offered to 180+ DPD borrowers, got it approved, and operationalized it entirely.
Payments concentrated at month start and end	Timed all outreach campaigns around these windows to maximise contact when borrowers were most likely to act.
HIPAA compliance across every channel	Operated within HIPAA constraints from day one across voice, email, and SMS without exception.

The Solution

Facing portfolio depreciation, the client lacked a collections framework, relying on two novice agents without multi-channel or settlement strategies. This forced the company to consider selling assets to debt buyers for minimal value. Skit.ai provided essential expertise and infrastructure, recovering more in the first month than the client’s expected quarterly collections.

Precision: Digital Nudge Strategy

• Pre-nudge emails notified borrowers of upcoming account calls, leading to self-resolution via payment links or preferred callback scheduling.
• Email served as the primary verified channel for sharing secure account information, which is restricted over SMS.
• The strategy achieved a 58% open rate and an 11% payment link click rate.
• This bucket required no human agent intervention and accounted for 64.3% of all March recoveries.

Scale: Multi-Channel Outreach

• Executed 28,860 outbound calls in March, focusing on incentives like continued card access and protection for future emergencies. The AI outbound calling strategy used subtle, non-pushy messaging tailored to medical borrowers.
• Achieved a 41.88% right-party contact rate through subtle, non-pushy call strategies.
• Delivered an integrated SMS layer, resulting in a 23.84% positive response rate.
• Generated 670 inbound calls from borrowers choosing to re-engage on their own terms following outbound outreach.

Deployment of Human Agents

• Agents were assigned to more difficult accounts where personalized conversation and judgment were essential.
• The tone of the conversation was adjusted according to the age of the account and the profile of the borrower.
• Accounts managed by agents achieved a 35.4% promise-to-pay rate in post charged off accounts.
• Agents primarily targeted accounts with 60+ DPD and managed inbound escalations along with special cases received through phone or email.

Resilience: Post-Charge-Off Settlements

• Skit.ai addressed the toughest segment by designing and operationalizing a tiered settlement grid for the client, which previously had no settlement framework.
• The strategy included a 40% payment settlement offer for borrowers at 180+ DPD.
• Post-charge-off collections reached a total of $35k over four months.
• This performance marked a significant increase from the previous monthly collections on these accounts.

The Results

What Actually Worked

Approach	What Changed	Outcome
Empathy-First Messaging	Calls focused on incentives (card access, future protection) rather than consequences of non-payment.	Borrowers recovering from medical treatment responded positively. Trust built with a medically sensitive customer base.
Digital Nudge	Pre-nudge email via verified source, followed by payment link. No human agents needed.	Bot-driven digital nudges secured 64.3% of March recoveries. Payments totaling approximately $18k were received from 14 accounts autonomously, requiring zero agent intervention.
Settlement Grid	Skit.ai designed and operationalized a 40% settlement offer for 180+ DPD borrowers.	$35k in post-charge-off collections. 17-20% collection rate on previously unrecoverable accounts.
Payment Timing	Outreach timed to first week and end of month, aligned to observed borrower payment patterns.	Higher contact-to-payment conversion during peak windows.
HIPAA Compliance	All collections conducted without patient health data across every channel from day one.	Compliance maintained throughout. Removed a common barrier for healthcare lenders.
Inbound Generation	Outbound campaigns across voice, email, and SMS drove borrowers to call back on their own terms.	670 inbound calls generated.

To Summarize

The client was close to selling its underperforming portfolio, which saw only $1,000-$2,000 in monthly recoveries. Managed by novice collectors without a settlement framework, the assets were nearly sold for minimal value until Skit.ai intervened. By implementing a specialized settlement grid and an empathy-first multi-channel strategy for medical borrowers, the team surpassed quarterly expectations in just one month. In four months, Skit.ai delivered a 5X ROI. This success proved that a compassionate, specialized approach is far more effective than traditional methods for borrowers managing medical expenses.