Importance of Patient Collections

Changes in the US healthcare system over the past decade have led to higher patient financial responsibility.  Per the Kaiser Family Foundation (2016), patient out-of-pocket expenses have increased substantially over the last decade, due to such things as high-deductible policies and greater cost-sharing expenses (e.g. co-pays, co-insurance).  As a billing company, it is our responsibility to inform our clients of the best possible means for collecting patient balances and to help maintain consistency in patient collections in our billing office and in the main office.

Cavanaugh (2017) provides some suggestions for increasing patient collections and maintaining up-to-date policies and education in the office.  I have considered these suggestions and added my own suggestions from personal experiences as well:

  • Staying Current on Payor Policies: It is critical for billing companies and office management to stay current on payor requirements for collecting patient balances. Most insurance companies put forth a set of requirements for collecting on patient deductibles, co-pays, and co-insurances.  Efforts must be made on patient balances before they are discounted or completely written off.  Failure to follow these requirements could mean a breach of contract, which could lead to contract termination and restrictions of contract-renewal.  MedPro Services’ staff strives to remain current on payor policies and we continuously inform our clients of these policies.
  • Patient Responsibility Policies: It is crucial for a practice to have a set and firm patient responsibility policy in place.  A patient responsibility policy may include how and when the patient will be billed, as well as expected payment timeframes.  A copy of the policy should be provided to each patient or is should be discussed verbally, but most importantly, it should be provided in a way that is accessible and understandable to every patient.  Make sure every staff member, at the front office and in the billing office, knows the patient responsibility policy.  This must be maintained consistently and with fairness for every patient.
  • Collecting Up-Front: Most insurance companies require that co-payments are collected at the time of service.  Prior to providing services, the office staff must check that insurance cards are current and collect the co-pay amount that is often listed on the front of the card.  If this amount is not listed, verify patient eligibility and co-pay requirements.  Taking these steps will ensure that accurate co-pays are collected at the time-of-service.  Communicate with office staff the importance of collecting payment up-front.  At MedPro Services, we communicate daily with the main office staff on patient balances, co-pays, and any credits that may result from overpayment.  Doing so allows patient balances to be collected up-front and in the correct amount.  If patients request greater clarification, our staff is always willing to discuss balance questions with the patient.
  • Documentation: It is simply good practice to maintain quality documentation in a medical practice and billing office. Anytime a patient calls or comes into the office, document the conversation to some extent in the patient’s account.  Document and keep record of all patient payments.  At MedPro Services, our personal policy is to maintain and keep substantial records of any patient communications and payments.  If ever for any reason a patient payment is not posted or there is a complication with a particular account, then our documentation will provide explanation and clarification in these instances.  We work best with clients who maintain good documentation in the main office as well.
  • Multiple Means of Collection: By providing multiples means of collections, providers are giving patients more opportunities to pay balances in full and on-time. Consider accepting a wide-range of credit card carriers (e.g. Visa, MasterCard, American Express).  MedPro Services offers our clients Zirmed Patient Payments through our clearinghouse, Zirmed, which allows patients to pay online, check balances online, and aids the office staff in balance collection.  In our modern society, streamlined and intuitive solutions such as these simply make sense when collecting patient balances.
  • Quick Payment Posting and Statement Cycles: Our billing company strives to post patient payments quickly upon receipt.  This helps to clear out balances and eliminates aging patient debts and the potential for duplicate payment.  We send statements out weekly and ensure that patient addresses are current to help avoid returned statements, and thus, unpaid balances.


Cavanaugh, M. (2017, May-June). Improve patient collections and stay compliant with payor requirements. The Journal of the Healthcare Business Management Association, 26-29.

Kaiser Family Foundation. (2016, September). 2016 Employer Health Benefits Survey. Retrieved from the Henry J. Kaiser Family Foundation website:

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