when patients refuse to pay

Many patients do not understand that their insurance company’s reimbursement does not cover the full cost of care. Next time a patient says he doesn’t think he should have to pay you (“My insurance company pays you. Why do I have to pay too?”), it might help for you or your staff member to explain, for example, that the insurance company allows $42 for the service (despite the fact that your full fee is $50) and pays you $32 because the patient’s health insurance contract says he owes a $10 co-pay at each visit.

Your staff must make it clear to patients who refuse to make their co-payments that they are actually in violation of their contract with their insurance company. Pointing this out may help patients better understand your role in the process.

Now that your staff has made it clear why the patient is responsible for paying, how can you help them collect from patients who say they can’t pay?

You and your staff have probably heard these excuses a million times: “I don’t have my checkbook [or cash or a credit card]” or “I lost my checkbook.” My personal favorite is “My checkbook [or wallet, etc.] is in my car. I’ll be right back,” followed by the sound of tires screeching in the parking lot as your patient makes a getaway.

Some of these situations are impossible to deal with. For example, I do not recommend having a staff member run after a speeding car to collect a co-pay. One strategy that does work well is to give these patients pre-addressed, stamped envelopes and tell them to mail their co-pay to the office. A few may scratch out the office name and address and use your postage-paid envelope to pay their electric bill, but our practice receives 96 percent of the envelopes back within two weeks, on average.

Your staff may want to ask patients who chronically resist paying at the time of service for their co-pay before you treat them. If they have left their means of payment in their car, this will give them time to get it.

Another good idea is to make sure your practice accepts credit cards. Credit cards have proven to be an important tool for collecting patient payments. Most patients have them, and they don’t have to be present to use them. For example, when a patient forgets to bring his wallet, checkbook and credit card to the visit, he can simply call you from home with a credit card number. It’s convenient for the patient, and it benefits the practice.