Tips for Working with Patients on Missed Medical Bill Payments

When patients fail to pay medical bills, it can place financial strain on physicians, healthcare facilities and medical practices. There are several ways medical providers can navigate these scenarios, and one of the most effective methods to handle the issue is prevention.

Proactive strategies that may help healthcare organizations avoid payment issues include price transparency, clear policies and payment plans. Regardless of which approach practices opt to take, the ramifications of each option must be carefully considered.

Here, MLMIC takes a closer look at how physicians and practices can address this increasingly common issue.  

How Physicians Currently Deal with Nonpaying Patients

Ripple effects from the pandemic and the rising cost of living make collecting medical bill payments in 2022 especially challenging. Physicians across the country deal with this in various ways. For example, according to a recent Medscape report, 43% of physicians continue to treat nonpaying patients and work with them to develop payment plans. Smaller fractions of those surveyed send bills to collections (13%) or continue care and write off the remaining balance (12%). Only 8% of physicians say they stop seeing nonpaying patients, and 25% choose other actions.

Preventing Missed Medical Bill Payments

As the saying goes, prevention may be the best medicine. The following strategies can help patients avoid unpaid bills and missed payments:

  • Develop a payment policy. According toMedscape’s Jennifer Nelson, having a payment policy sets expectations and prevents surprises for patients. Nelson recommends including the payment deadline, a description of how co-pays and deductibles are handled, details on accepted forms of payment and policies on nonpayment.

    In an article for the American Academy of Family Physicians, author Robert B. Connelly recommends providing new patients with a copy of the policy, ideally before their visit via postal mail or email. Once the patient arrives in the office, he suggests having a staff member outline the policy and secure a patient signature. It can also be helpful to post copies of the policy around the office, especially near the reception desk.
  • Provide price transparency. “Patients are more likely to pay their bills when prepared for the expense,” writes Nelson. New price transparency legislation requires hospitals, health plans and insurers to provide costs up front, and Nelson recommends that physicians do the same. 
  • Offer payment plans. Payment plans that allow patients to pay expenses over weeks or months offer an important alternative for individuals who can’t pay bills in full at the time of service. Payment reminders can also be useful. If a patient misses a payment, Connelly advises that staff follow up with the patient over the phone to politely seek information. If the patient can’t be reached, a follow-up letter should also be sent.
  • Hire a patient advocate. These staff members can guide patients to specialists, pharmacies and additional resources that support health—all of which help control costs, says Connelly. Patient advocates can also advise on payment issues, develop payment plans or make referrals to medical assistance programs.

Further Tips and Considerations

In addition to instituting the proper procedures and policies, there are other actions physicians and medical practices should be mindful of when addressing non-paying patients:

  • Separate physicians from the financial aspect of care. “When discussing payment policies, physicians should try to distance themselves from the actual collection process as much as possible,” Nelson explains. “Well-meaning physicians often tell patients things like they can ‘figure something out’ financially or ‘work them in’ during a scheduling conflict, but that often undermines the authority and credibility of the practice’s office staff.”
  • Keep detailed records and documentation, which will be of critical importance if pursuing legal action to collect debts.
  • If choosing to discontinue the physician-patient relationship, be sure to consider the potential legal ramifications. In the Risk Management Tip “Discontinuing the Physician-Patient Relationship Properly,” MLMIC emphasizes the importance of documenting patient disruption, establishing a formal process for discharge and sending written discharge letters through certified mail. 

Additional information, including form letters and a memorandum on the discharge of patients, is available from Mercado May-Skinner. Contact MMS in Syracuse at (315) 428-1380, Colonie at (518) 786-2880 or Long Island at (516) 794-7340 or (877) 426-9555.