22 Jul Best Practices for Patient Balances

Many of us have felt the gradual increase of medical costs due directly from the patient, both within our businesses and our own pocketbooks.  Particularly with the growing popularity of high deductible health plans, physicians have to contend with a larger portion of their accounts receivable due from their patients as opposed to their patients’ insurers.  As a result, these patient due balances need to be treated in a way that is as structured as the way we handle payments due from insurance companies.

If insurance company A had an open balance aged to forty-five days, we would reach out to find out what was wrong, and implement any necessary remedy to achieve payment.  If insurance company A presented to our office with this unpaid balance, one of our first questions would be “How would you like to take care of your balance today?“.  We need to view patient balances with a similar urgency and structure as we view insurance balances.

Here are some helpful hints for collecting patient balances effectively in your office:patient balances


  • Many front desk staff are not naturally comfortable collecting money.  Do not leave them to their own devices for this important task.  Provide them with a script to help guide them in the best way to initiate this dialogue with patients.
  • If space allows, provide a private space where staff can talk frankly with patients about their balances.  Patients will feel more comfortable explaining any financial difficulties they may be having which will give your staff an opportunity to work with them on ways to get the balance paid.
  • Track your practice’s progress with collecting balances from patients. Try to track productivity of each of your staff so that you can identify whether you have specific staff who need extra training and assistance.
  • Formulate a plan for follow-up communications to patients regarding their due balances.  If a patient did not pay when they recieved their tenth statement, it is unlikely that the eleventh statement will drive a change in behavior.  Devise a system that combines statements with increasingly urgent letters sent to the patient.  Consider setting a dollar and aging threshold at which you dismiss the patient from your practice.
  • Proper follow-up on patient due balances is a costly, but necessary, operation for your practice.  The greater the age of the balance, the less likely it is that you will be able to collect on the balance.  Consider setting a balance threshold at which point you will forward the balance to a third party for further collection assistance.  Although these parties charge a percentage of their collections, it is likely a better overall financial decision for your practice to release your employees from focusing on the collection of very aged balances.


Kathleen Heaton has worked in health care and business operations for over thirteen years, rising through the ranks to perform specialized roles in several capacities.  Kathleen came to PediaTrust, LLC and speroMD from Ann & Robert H. Lurie Children’s Hospital of Chicago, where she was Operations Manager for the independent Children’s Community Physicians Association.  Kathleen is an industry expert in credentialing and managed care contracting, and her primary focus is to oversee revenue cycle management for speroMD’s partners and affiliates.  She is the co-chair of the Practice Management Workgroup with Lurie Children’s Epic Community Connect program.  Kathleen is currently enrolled at Loyola University in Chicago for her Master of Jurisprudence in Health Law.  
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