What is your policy regarding nonpayments in private practice?

[DXM1]

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How are you guys handling nonpayment for services in private practice? Scenario would be if a patient ignores bills after a certain time window - say 2 months or so after insurance has paid their portion and it becomes clear what the patient owes. Also assume payment plans are an option and were discussed with patient at initial visit, but they have made no effort to pay the bill.

Are you sending bills to collections? discharging patients? writing it off? Charging their credit card (if so, then are you doing this immediately when it becomes clear what portion the patient owes for the visit, or perhaps after a certain time window?).

Also, i assume that for copays and no show visits, you would charge this on the day of service (or missed appointment)?

Just trying to understand what is a reasonable and generally accepted practice on how to deal with this.

 

[FlowRate]

I don't have much experience with this subject, but it seems like the "hypothetical" changes quite a bit if it's a patient who's still seeing you somewhat regularly vs someone you never expect to see again.

 

[calvnandhobbs68]

lots of times it's a lost cause unless they're coming back to see you from what I've gathered over time. If you have a credit card, charge it after 30 days, that should be a pretty standard part of your intake paperwork. If they're coming back to see you, charge it on the next visit or tell them you can't keep seeing them with unpaid bills but either way you need to be clear about what'll happen (pay X amount within X number of days or you'll be discharged).

I really like people who have any kind of deductible to have a credit card on file so you don't end up with hundreds of dollars in unpaid bills and a patient ghosting you but that group I'm with doesn't require it.

Copays and no shows for sure you should be charging day of service. I mean we don't do this but I know specalists esp for procedures who charge the expected amount up front for anyone with a deductible and then refunds them if their insurance pays for it. This is more and more of an issue as more people end up with deductibles in the thousands of dollars and feel comfortable bailing on trying to pay for it.

 

[randomdoc1]

I'm very firm and crystal clear about finances before even letting a patient schedule for the first time to establish with me. And at that first visit, I charge the card on file in session. It nearly eliminates the issue. There is a high clinical correlation with complexity of the case and the financial outcomes. Being clear about that boundary helps curate a population that is committed to engaging in the treatment and respecting your realities as someone who is making an honest living. If they have true financial hardship, patients who are respectful of your own responsibilities are often willing to come up with a plan together, even if it means transferring to a more affordable setting. If despite this the patient continues to push that boundary, I discuss transition of care to a different setting.