Abstract: A system for generating customized patient billing communications includes software executing on a server which receives patient billing data indicative of a patient visit and further indicative of a balance. The software accesses a storage to determine patient visit context data indicative of one or more visit codes associated with the billing data. The software generates a communication for a user based on the patient visit context data with message content altered from a standard message based on the one or more visit codes, the communication including a bill for the balance and being a first communication to the user with the bill.