Practice Management Alert

Question: I'm new at my job working at the front desk of a small, independent practice, and I'm worried about the risk of confrontation over nonpayment. Colleagues who have been here forever say it has never happened, but our town is growing and we're getting new patients all the time. What do I do if someone refuses to pay?

Ohio Subscriber

Answer: While worrying about unknown situations probably isn't helpful for falling asleep at night, it's a great quality to help round out your practice's policies. Establish a policy that includes these steps; ensure your practice gets the money it charges for services (and which patients agreed to pay), without losing face or engaging in arguments. In the moment, focus on avoiding or minimizing confrontation.

Also, try to follow this advice:

1) Defuse the situation. If a patient refuses to pay, make sure the patient feels heard, and let him see the physician during his scheduled appointment.

Remember: If there are other patients in the waiting room or even in exam rooms, they will probably overhear an exchange, especially if you or the patient uses raised voices.

2) Send a balance statement right away, and follow up with a phone call. Remind the patient that he agreed to pay the copay fee in order to be seen, and that he may not book another appointment until the balance is paid in full.

3) There's no set timeframe for you to pursue a payment, but experts recommend a maximum of three months.

4) Refer a balance to a collections agency as a last resort, as your practice will obviously take a financial hit.

5) If you choose to end the relationship with a nonpaying patient, you're entitled to do so, but cover your bases by terminating the relationship in writing. Legal experts recommend sending a certified letter.