Where patient balances come from
Deductibles, coinsurance, and copays under high-deductible plans. Services the plan denied or did not cover. Elective and cosmetic work. Missed-appointment fees. Payment plans that stopped after two installments. Balances left when a patient moved or changed insurance and never updated the office.
How practices get stiffed
- "Insurance covered it." The patient assumed the plan paid in full and treats the statement as a mistake. After the third statement they stop opening the envelope.
- Wrong or expired insurance at intake. The claim is denied months later, the balance becomes patient responsibility, and the patient disputes a bill for a visit they barely remember.
- The abandoned plan. A payment arrangement that was honored just long enough to get the work completed.
- The after-the-fact dispute on elective work. Crowns, implants, aligners, cosmetic procedures: completed, then "not what I expected," then unpaid.
- The patient who moved. New address, new number, no forwarding information, and a statement cycle that keeps mailing into the void.
- The chargeback. A card payment reversed weeks after the visit.
Warning signs
- Statements returned undeliverable.
- A balance that has been through three statement cycles with no contact from the patient.
- Payment plan installments missed twice in a row.
- Disputes that reference the outcome rather than the charge.
What to do before you place the account
Confirm the balance is truly patient responsibility: the claim was adjudicated, the explanation of benefits matches, and any adjustments are applied. Gather the signed financial policy or treatment consent, the itemized statement, the EOB, the payment plan agreement if there was one, and the statement history. Send a final notice with a date. Then place the account rather than letting it age; the chance of collecting drops sharply after a year.
How we collect for practices
Patient balances are consumer accounts. Our collectors are trained on the Fair Debt Collection Practices Act, the Fair Credit Reporting Act, and the Gramm-Leach-Bliley Act, so recovery never comes at the cost of compliance, and patient information is handled HIPAA compliant. We make consistent contact, locate patients who moved through skip tracing, and negotiate payment professionally, which is why most of our clients keep the patient once the balance is resolved.
You see every account online at any hour, choose which accounts to place and which to leave alone, and pay nothing unless we recover. If a balance cannot be collected, we recommend closing it at no cost to you.
Common follow-up questions
Is a collection agency allowed to handle patient information?
Yes, under the same privacy rules that apply to your practice's business associates. We handle patient balances HIPAA compliant and collect under the consumer collection laws.
Will sending a patient to collections end the relationship?
Usually not. We collect firmly but professionally, and most of our clients keep the patient once the balance is resolved. You decide which accounts to place.
How old can a patient balance be?
Old balances can still be placed and worked, but the best window is 60 to 90 days past due, and collectability drops significantly after a year. Send accounts early.
Talk to us
Tell us about the accounts and we put together a free assessment, usually within one business day. Request a free consultation, contact us, or call 321-710-3530. Ready now? Place a claim and we go to work today. No recovery, no fee.