Patient payments for medical practices

Here’s a simple guide and patient payments software for collecting payments from patients. Nowadays, patients are responsible for a larger portion of their healthcare costs. Traditionally, doctor offices have either written payment dues off as bad debt or have simply let those patient balances due slide to avoid damaging relationships with patients. Most practices that we talk to, or work with, do not have a credit card on file program before we start working with them.

Medical practices need to collect every dollar they’ve earned. Here are a few things you need to get started.

Front desk collections of patient payments

Arguably, the biggest bang for the buck is to ensure that your front desk is respectfully aggressive with collecting account balances from patients. You need to stop allowing your front desk to “mail the bill” to the patient as many patients ask them to do. In our experience, most patients do NOT pay unless you are asking them to pay. Our medical call center team also does patient balance collections and have reported similar results. 

You need to hold your frontdesk staff 100% accountable for collecting copays and past due balances. Organizationally, you could even have a monthly competitor and maintain a leaderboard to reward top collectors.

Patient payments plans

Patients are willing to pay, however, many times they are unable to pay. Medical practices need to have well defined payment plans set up. Front desk and payment collection agents in your call center should be made well aware of these payment plans. 

In our call center, we do not allow payment plans for more than 6 months – however, this is a decision that each medical practice needs to make for themselves. In our experience , patient payment plans of more than 6 months do not seem to do well as patients change their credit or debit cards. 

Patients also have options like Carecredit, ProsperHealthcare, LendingClub patient solutions etc. to get financed.

Set payment expectations and cost of care before patient’s visit

During your patient intake process, your patient intake software should be able to give you a cost of care estimate. Ensure that you run an insurance eligibility check for the upcoming appointment before you call the patient and when your front desk or call center agent is speaking with the patient about their upcoming appointment, make sure you let the patient know what their current balance is and what their upcoming appointment cost might be. This truly does help collect more from patients. 

Yes, there will be cases where patients will cancel appointments if they learn about a past balance due. Think about it this way – would those patients have paid at all? You are better off cancelling the appointment if that patient was not going to pay in the first place!

Explain options to patients

Most front desk and call center staff do not take the time to explain the complicated terms to patients. Patients do not have a clear understanding of copayment, coinsurance, deductibles, out of pocket maximums etc – at least not as much as you and your practice staff do.

Take the time to explain these differences to patients (in other words, spend some time in educating them). The more you educate the patients, the better your chances are of collecting patient balances, ensuring patients are well aware of their visit costs, and preparing for the payment in full (PIF) – whether it is on the date of service or over a few months, on a payment plan.

Send patient payment reminders

One thing we have noticed with our patient debt collections agents is that when they call the patient with a reminder about their balance due, patients do actually end up paying. Payments from patients thus far have been primarily via credit card, debit card and on very few occasions, using ACH / check. 

Sending a payment reminder SMS and an automated way for a patient to see their balance due goes a long way towards collecting patient balance due. If you cannot send a HIPAA secure link with the patient statement in the SMS, then it is better to not even send the payment reminder SMS. In our experience, patients always ask for an explanation of why the balance is due before they actually agree to paying in full, part etc.

Balancing payment collection with greeting patients

This is where most front desk staff struggle the most. They are tasked with providing the best patient experience possible – smiles, warm greetings, building a relationship with the patient to make them comfortable etc. It is hard for them to balance their patient greeting with asking for payments. 

While the patient balances for regular visits are not very high, the balances for surgical procedures can tend to add up to amounts of significance. This is where the surgical coordinators can be of the biggest help. 

As an example – in our ophthalmology group customer’s practice, the surgical density is quite good. For this practice, our doctors recommend a procedure to the patient and then the patient is taken to a separate surgery scheduling waiting area. The surgery scheduler / coordinator is actually in the best position to collect patients’ payment responsibilities.

Just like with the call center staff (or front desk), surgery coordinators should take the time to explain to the surgery candidates / patients that their doctor is recommending a surgery, what the next steps w.r.t clearances are, who is responsible for each step, then finally explain the total costs and break it down into patient’s insurance coverage vs deductible vs the patient portion of deductible that has / has not been met and what the patient would be responsible for. At that time, the scheduler should ask the patient for the patient’s responsibility portion to be paid upfront – BEFORE the surgery is scheduled. 

Sure, some patients would cancel their surgeries if they are told what their payment responsibilities are – but these are also the same patients that would never pay their balances anyway. Unless your practice is OK with collecting only the insurance portion (hey, something is better than nothing), this is the route we recommend taking.

Set up credit card on file program for patient payments

This is, by far, the best method we have seen thus far. Our patient intake software along with our call center asks every patient to set up credit cards on file before they come in for their visit. Since many of our patients are of the Medicare/Medicaid payer mix, they do not, typically, have much of a balance to pay – however, for the commercial insurers, there’s almost always a patient payment balance.

Our front desk staff are instructed to ensure that payments are made with credit or debit cards with an explanation like “we try not to have cash in our practice locations”. This allows our practices to have a credit card on file. The front desk staff are also instructed to explain to the patients that under a mutually agreed upon balance (e.g. $200), we would be allowed to charge their credit card for the patient obligations.

Athena has a wonderful study + recommendation that you can read here.

Patient payments using a bill pay software

Our patient bill pay software is a simple tie in using Stripe. You can see one of our patient bill pay software in use here. Whether patients are sent a payment link via a payment reminder SMS or directed to it from the customer website, the patient can simply enter their name, card number and pay. They get an email receipt of their payment that they can use for proof of payment. Meanwhile, they also have the option to select post dated and recurring payments as well. 


In addition to the patients being able to use this software to pay their payment responsibilities, our call center staff also uses the same portal to make payments for the patients when they are speaking with the patients about their balances due.

Each day, at the end of the day, Stripe automatically deposits the monies collected to our customers’ bank accounts and each day, the transactions are downloaded and tallied against the balances due by our medical billing team. These payments are then posted against the patient’s account daily to ensure that the patient account always reflects the correct account balance.