Automated vs Manual patient payment systems

  • 6Minutes

In clinical research, patient payment systems play a crucial role in compensating participants for their invaluable time, effort, and incurred expenses. Traditional manual systems often limit payment options and only do basic stipends and reimbursements, resulting in rigid and slow processes that hinder patient recruitment and retention. However, the emergence of modern automated solutions like SkyePay has transformed the landscape, offering unprecedented flexibility, efficiency, and ease of use for both research sites and participants.


What are the most common types of patient payments?

Stipends/Per Visit Payments:

Participants receive a fixed amount of money for each study visit they attend. The amount may vary depending on the complexity and duration of the visit.

Reimbursement for Expenses:

Participants are reimbursed for out-of-pocket expenses related to their participation, such as travel costs, parking fees, or meals during study visits.

Completion Bonuses:

Participants receive a bonus or additional payment upon completing the entire study. This is often used to encourage participants to remain in the study for its full duration.

Incentive Payments:

Incentives are additional payments given to participants for specific actions or achievements within the study. For example, completing a survey, meeting certain milestones, or achieving specific health-related goals.

Gift Cards or Vouchers:

Instead of cash, participants may receive gift cards or vouchers that can be redeemed at specified retailers or service providers.

Hybrid Systems:

Some studies use a combination of the above systems to tailor payments to the specific needs and circumstances of participants.

Manual patient payment systems

Rigid payments

Typical manual patient payment systems only do basic stipends and expenses, without much customisation. Patients also have less flexibility with how they are paid. The most common is a bank transfer, which is only useful if you have a bank account. According to the World Bank’s latest report, nearly 1.7 billion people are unbanked globally. That’s close to one-fourth of the global population. If a study only pays via bank transfer then it risks alienating a huge population of people around the world, resulting in less diversity in clinical research.

Another payment choice typically offered is a prepaid debit card, but even this isn’t without drawbacks. Prepaid cards often carry many hidden fees, such as inactivity fees, or even to withdraw cash from an atm. Not giving patients choice and limiting them to incompatible payment methods, makes patient recruitment a lot more difficult and costly for the study.

Typically, manual systems only pay in USD, this leaves a big gap and limits the types of studies that can be supported by these types of patient payment systems. It also means that anyone not being paid in their local currency will suffer exchange rates and fluctuations.

Manual and slow

Manual Payment Systems are often cloaked as automated, however payments are actually handled by people behind the scenes. Payment solutions like this take the onus of the sites and sponsors and give the illusion of automation. They provide tools to sponsors and patients, and solutions like these can do stipends expenses and drive. However, these are in reality just a portal to view what was processed behind the scenes by people. Unfortunately, this means delays in payments and expenses as oftentimes the approval process requires offline discussions for approval and actually can take days or weeks to make payments.

When time is crucial, manual patient payment systems are often slow to pay patients, leaving them out of pocket for many days. Slow payment processing times can lead to frustration and dissatisfaction among participants, potentially compromising their willingness to remain engaged in the study. Delayed payments may also hinder patient retention efforts and impact the overall integrity of the research. Having timely payments along with transparency on payment processes, including payment schedules and amounts is essential for building trust and maintaining participant confidence in clinical research studies.

Traditional patient payment systems typically require a lot of admin by site staff, who we know are already time-short. Cumbersome administrative processes, including manual record-keeping and reconciliation, contribute to inefficiencies and may divert valuable resources away from patient care and study management.

Automated patient payment systems

Using an automated patient payment system like SkyePay, carries many benefits to everyone involved in the study, from the site and its staff – to the patients themselves.

Quick and efficient

Adopting a payment system like this significantly cuts down on the administrative burden placed on medical staff. Allowing them to better spend their time on more important things, like patient care. Because Skyepay is quick and intuitive to use, it doesn’t require any of the training that typical systems need, which is sometimes as much as 20 hours.

It is so efficient in fact, that the time it takes from logging into the system to paying a patient, is under a minute!

SkyePay has both an internal and external API to make things even smoother. Being able to connect with a CTMS and other software drastically reduces the admin time, as staff don’t have to repeat entries or duplicate tasks. The scale of this time saving is more apparent when a majority (60%) of sites are using 20+ technology systems on a daily basis.


SkyePay has the flexibility to handle every payment type, stipend, batch payment, diary entry or trigger payment along with expenses including drive – you can even customise expense types and categories.

This flexibility extends even to the patients, as they get to choose how they want to be paid for each and every visit. Whether that’s through card payments, bank transfers, virtual cards, PayPal or Venmo, the choice is theirs. Giving patients the choice and ensuring payments are made quickly and efficiently leads to greater patient retention in a study. It also supports multiple payees, enabling reimbursements for a parent or guardian who is also incurring expenses for a study involving their child, or a carer for an elderly person.


Using a modern solution like SkyePay means that companies can identify and track all payable items (based on procedures, study events, or milestones) at both the study and site levels. Real-time dashboards provide full visibility to upcoming and pending payments, to optimize execution and cash flow. This means that payment approvals and the study funding levels can easily be monitored and updated with minimal effort.


If you want to see how SkyePay compares to typical industry solutions, view our feature comparison table.


Skyelarke is the most intuitive, comprehensive and affordable system for automated patient payments.