Collecting Patient Payments

Shaking handsWith out-of-pocket patient responsibilities increasing, it has become more important than ever that provider front office staff, billing and billing companies collaborate their efforts in collecting patient balances. Statistics for the “average practice” show that a providers accounts receivables (AR) revealed more and more delinquent patient accounts than in the past. Those statistics showed the reasoning for so much AR becoming delinquent was due to things like large deductibles, unpaid co-payments and co-insurances, no active insurance coverage, coordination of benefits issues, missing or lack of complete insurance information, incomplete workers compensation information, etc. This was resulting in large chunks of money being left on the table.

Don’t worry!! There is a solution that will help decrease the number of delinquent accounts. With staff training, incentives, and collaborative effort from front end provider offices and back end billing staff and services, you should start to see results after a few months. Here are few strategies that will assist with lowering delinquent accounts and in the end increase the bottom line.

Check Eligibility Benefits –

Checking eligibility and benefits is something that should be done all the time and every time as a requirement, not an option. This should happen at the same time as the front office takes a co-pay before the patient sees the doctor. If a co-pay can’t be made at the time, inform the billing staff to send a billing for the copay at the same time they submit a claim to the insurance. If a patient participates with coverage the provider is out-of-network with, or the patient has inactive coverage, collect payment upfront before the patient is seen. A fee structure or schedule for self pay patients will help keep consistency and equal treatment for all self pay patients and increase efficiency on front end staff.

Collecting New & Old Balances –

There is no better time to collect than when a patient is standing in front of you at the office. If they’re in the process of paying a copay, try to get them to pay old balances at the same time. For providers using billing services, coordinate balance information from them with your Electronic Medical Records (EMR) or scheduling software so the front desk can see outstanding balances. If the software capability is not available, use reports to keep your front desk staff up to date with any outstanding balances.

Patient Education –

An ever growing demand from patients is transparency in healthcare costs. More and more patients want to know what their costs will be and why are they receiving statements billings. Having a plan in place to educate patients on insurance billing and costs will assist in the patients good will and willingness to pay. Provide patients a frequently asked questions (FAQ) pamphlet for them to read in the waiting room. Post signs and notices around the waiting room and in exam rooms. Terminology is also something patients are confused by. Give them information on definitions and billing concepts for things like Co-pay, co-insurance, deductible, etc. so when they statement comes in the mail they no what to expect.

Coordination of Benefits –

Educating patients on their coordination of benefits will also help in avoiding denied claims and billing errors. If there is ever a change in the patients information (address, spouse info, employment status, auto accidents, etc.) The patient needs to be aware it is their responsibility to contact their insurance carriers to coordinate those benefits and changes.

Verify Patients Address –

With every patient encounter, or at least monthly, verify the patients address and demographic information. This is very simple but usually always overlooked. It also plays a key role in collecting money from patients.

Online access –

For those without online access for making payments and patient account information, now is the time. The American Medical Association conducted a survey in 2011 in which fifty percent of adult patients said they would consider changing doctors if it would give them access to online bill-pay and account information. By 2016 it is estimated that $300 billion will be spent on online transactions.


With the implementation of these strategies and the coordination of front office staff, back end billing or billing services, delinquent accounts and rising AR should begin to show a downward trend within a few months, and show an improvement to your bottom line.