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Patient Payments Blog

Scripts For A Softer Approach To Collecting Past Due Balances

Posted by Jim Turner

Aug 9, 2017 8:37:00 AM

This post is the ‘how to’ for last week’s post ‘One Call Collections For Past Due Balances’.

agent-18707_1920.jpgI have a confession. I used to be a collector. The job was a promotion from being a lowly clerk in an accounts receivable office. I was excited; more money, prestige, moving up the company ladder. My excitement lasted until the first profanity laced ‘I got no money’ tirade. After about my third call I learned that fun and collecting were at opposite ends of the spectrum. It’s not a job for the timid.

Given the difficulty, how do we make a hard job a bit easier on ourselves and our patients? I’m an advocate for taking a softer approach – provided that you’ve done a great job of patient education and care from the start.  Taking a softer approach can often lead to better results.

If you have taken pains to educate your patients on your payment policy and communicate it clearly, you have laid a great foundation for this approach. If not, then a revisit to some of our front desk, marketing, and other discussions may be in order. Once the front-end payment discussions are well planned, the backend discussions become much easier.

Here’s the approach. It will take more time on the first call but you will eliminate the need for future calls.


Make it more about the patient.

Because we have a vested interest in the practice and the payments needed to keep the practice healthy we often overlook the patient’s viewpoint. Yes, it’s true they owe the practice money and the ultimate goal is to get paid. But, the patient has a personality, a life, a health issue, and a budget they have to meet. Keeping these in mind will help billing staff become an extension of the healthcare given by doctors and medical staff.

Once the patient is on the phone, start with questions about them. “How are you feeling? Do you have any further needs? Do you anticipate needing another appointment? (provided one is not already scheduled) Did you have any questions for our medical staff?” Be human – care about the patient and not just about the payment! Give the patient a reason to not ignore your call the next time.

Invite patients to ask questions.

After you’ve covered their care and present condition, transition to the billing. Good transition statements will sound something like, “I’m so glad you are doing better, do you have any questions about your bill? Thanks for letting me know those things (be specific), have you had a chance to look at your billing statement?”

One rule of thumb: Asking questions is a gentler approach than making statements. We are often so intent on getting to the point that we sound harsh like, “The reason I called is to get an arrangement on your outstanding billing. I called to discuss your past due account. I need to make arrangements to get your account up to date.” All of these will negate any effort you made to connect with the patient. Train yourself to ask questions – they invite the patient to participate in the solution!

After asking the questions, take the time to explain the answers in as much detail as the patient needs. They will feel more confident in paying the bill. None of us like to pay bills we don’t understand!

Give patients realistic options.

After fielding the patient’s questions about their health and the billing, you have a perfect opportunity to ask for payment. Again, use a transition statement like, “I’m glad I could help you understand the billing and how the insurance works, what arrangements for payment can we make today? Are you able to pay the full amount?”

Always ask for the full amount. It sets your expectation with the patient. Depending on the balance, they will most likely say they can’t. That’s ok – you have options.

I’m going to assume you have some basic tools. You have a way to hold their payment card on file for a future transaction. You have a way to set up automated recurring payments. You have office policy that gives you guidelines for what you can offer.

When the patient says they can’t pay the full amount say, “That’s ok” - WHAT – hold the presses. Did a collector just say it was “OK” if I couldn’t pay today? Yes, you just said that and it was very meaningful to the patient. You just took the pressure off. When you asked them earlier if they could pay the balance their stress level started to rise. When you offer alternate options, you become the hero!

After letting the patient know it’s ok, ask them questions like, “When do you think you could pay? (Now you have an anticipated date) Will you be able to pay the full amount on that date? (Now you know if he or she needs a payment plan) If not, how much per month fits your budget? (Again, it’s about the patient’s budget, not your need to collect it) If the patient’s budget is less than office policy say, “I wish I could do that for you, our office policy requires $___ monthly. Could you possibly stretch and meet that?” (Now you have an acceptable arrangement)


Don’t stop there though. Arrangements that don’t have a payment card on file to back them up are no good. The patient forgets, they don’t have the money on the required date, etc. Then you are back to square one.

Instead, end the conversation like this, “I’m so glad we could make arrangements that work for you. All I need is a credit or debit card to put into the system so all this happens automatically. That way it’s all set and you can rest assured it’s taken care of.” The patient may be reluctant to give up their card number but you can reassure them that the system is secure and their information will not be at risk.

As I stated, this approach will take longer on the first call. Compassion almost always takes more time. But in the end, you will have gained the patient’s confidence, they will feel cared for instead of feeling like just a number. Since you will have their payment card information and permission to use it, you will have eliminated any need for future calls. Both the practice and the patient win.  

For more on proven strategies to collect more in a patient friendly way, download the Guide To Card On File Payment Solutions you'll find in the right sidebar on this page. 

Topics: healthcare payments, medical practice management, Credit Card On File, Patient Collections, Patient Centered Practice, Patient Collections Culture, practice management, Front Desk Tips, Back Office Tips

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