How providers must implement strategies to collect on outstanding patient balances?

As reforms continue to alter in the healthcare industry, it is affecting practitioners/hospitals, insurance providers and patients. Deductibles are increasing and the payments are increasingly becoming the patient’s own responsibility. Therefore, patients are becoming more involved and active regarding their insurance plans and payments which can at times be overwhelming for the practitioners to collect co-pays and other balances timely and accurately.

As per a report by SuccessEHS, 21% of the revenues from the patients are only collected upfront, implying that around 79% is left on the table. That’s a huge amount for any medical billing service provider.

Hence, here are some strategies which must be implemented to collect patient balances on time to avoid any outstanding:


The first time a patient calls for an appointment, it is the responsibility of the front-desk staff to inform the patient about his/her financial responsibilities and collect the co-pays before the service is due. Hence, the staff must be completely knowledgeable about the various policies implemented by the hospital. They should be able to check the patient demographics and accounts and remind the patient about the past-due balance (if any).


It is before the patient visits the hospital for the service, the staff must be aware of the patient’s payment plan, health coverage, co-pays or other financial liabilities of the patient. This also aids in estimating the costs of services, which includes procedural charges, pricing between organization and insurance provider, patient insurance benefits, etc. Finally, this will also enhance the chances of clean and complete claims, along with the reduction of denials, rejections or appeals.


In case the patient has not paid during his/her first visit to the hospital/clinic, it is best to collect the charges upfront when the patient schedules the next appointment. If not collected this time, it just may never be collected.

Credit card information:

If PCI guidelines and payers allow, the hospital can always keep credit card details for further payments. Co-pays can be made via HSA or credit cards.

Financial options:

Although all patients would ideally like to settle their bills on time, it is advisable for the hospital to make some financing options available such as EMI, discounts, etc. through cheques, credit cards, debit cards, Paypal, mobile applications or patient portals (for eg. a pediatric service may allow for some credits, say, for a sibling, to be transferred from account to another, which can eventually reduce the patients’ bill giving utmost comfort to the patient).

Internal collections:

It is best to collect dues internally rather than get into bad debt (less than $14 collected for every $100) and then move to third-party collection agencies. It is best to keep a tab on the number of reminders (letters etc.) as it costs money to send those too. Eventually, when the patient pays up (due to the retrieval body being a collection agency) to prevent their name being removed from the services, the original provider gets pennies for the dollar.


Use technology to its maximum. Regular reminders or kiosks with information displayed about payments displayed all over on the hospital boards can avoid the need of asking the patient upfront to pay.


Also, it is advisable to meet with the staff regularly to monitor the payments inflow and find ways of improving practice collections; and is essential to keep the staff motivated through incentive programs.

The healthcare industry is transforming. Though it is inevitable that there will always be unpaid balances and loopholes, it is vital to collect the revenues forthright. Practitioners and staff in hospitals work hard too, they must be given their due. For more details about the outstanding patient, balances click here: or call us on:- 888-357-3226.