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Polite form on chart collects balance due at registration

Because staff don’t like asking patients for money, one manager set up a non-confrontational form that gets patients to pay their outstanding balances at registration. The billing department attaches it to the charts each morning, and the front desk staff hand it to patients with, “Oh, by the way, there is a note here for you from the billing department.”

The form was designed for a four-physician, 10-staff family and internal medicine practice in Oregon. At the top of the form are the date, the patient’s name and account number, and the amount the patient owes, not the insurance balance. Below that, the biller checks the reason for the payment which can be customized to fit any office. This particular office lists copay, coinsurance, and deductible. There’s also a box for “no insurance,” meaning the patient is self-pay and owes the entire amount.

There’s also a box for “need insurance information,” which is checked when the patient forgot to bring the card at the previous visit. For that situation, the form shows the insurance payment due, and when people see they owe $8,000, it’s amazing how quickly they can find their cards.

When the receptionist gives the patient the form, she asks, “How would you like to take care of that today?” Most patients pay in full right there, but, if not, the receptionist asks, “How much can you send in?” Then the patient fills out the bottom section where there’s a line saying, “I agree to pay $ ____ by (date)” followed by another line for the signature. If the money is not paid by that date, the office begins its collection calls, starting with, “We have a form you signed stating you would send $X by this date.”

If the patient has questions, the receptionist steps out of the picture with, “Let me get our biller for you. Would you like to talk with her here, or would you be more comfortable if I take you back to the billing department?” Most of the time, the response is, “Oh, never mind. I’ll pay.”

When the office began using the form, it saw an immediate increase in patient pays of about 35%, and that level has continued. Moreover, there’s little resentment toward the form. It’s a nice way to explain quickly what’s owed and why.

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