PTPN Insights

Personal relationships are key to collecting from patients.

March 22nd, 2013 |

Personal relationships are key to collecting from patients. With patients’ copayments, deductibles and other out-of-pocket payments continuing to rise, many therapy practices are finding collections to be more of a challenge than ever. And while much of the advice and expertise on collections focuses on the numbers — aging reports, settlement amounts and so on — PTPN’s experts say that the key to successful collections may lie more with the personal touch.

“The best way to collect from patients is to establish a relationship with the patient when they first come to your practice,” says Stevyn Voyles, COO and vice president of Progressive Physical Therapy (a PTPN member with four locations in Southern California) A pre-existing relationship with the clinic administrative staff is likely to make a collections phone call down the line much more comfortable and productive.

If you’re responsible for billing and collections for your clinic, it’s in your best interest to develop relationships with each patient before the account ever gets to the collections phase. Whether in person (preferably) or on the phone, build a rapport with the patient. Think about discussing the following topics with them at the beginning of their treatment:

  • Explain your role and make sure he knows your name.

  • Review his insurance coverage, if he has any, with him and ask if he has any additional questions or anything else you can help with.

  • Make sure to discuss how he would like to pay for the account, and let him know his payment options (cash, check, credit card, debit card, web payment ability if you have it, etc.).

  • Be sure to give the patient your name (again) and contact number, in case he should ever have a question about his bill.

PTPN Vice President Nancy Rothenberg cautions billing managers to know their office policies, and to make sure the front desk staff does as well. While the patient should expect to pay his portion of the bill each and every visit, will the practice let him pay his portion once a week even if he is coming into the office two or three times a week? How flexible is the office when a patient asks this question? What is the procedure for when the patient doesn’t pay, or he forgets his checkbook or credit card?

Make sure the practice employee that collects at the time of service, usually the employee manning the front desk, knows if the patient is behind on any payments and, if so, what to do about it. One good practice is to direct the front desk to ask the patient for payment the next time he comes into the office. If the patient continues with excuses for not paying, have the front desk person tell the patient which person in the practice will be contacting him regarding his account.

When calling the patient for this follow up, keep the conversation as pleasant and non-confrontational as possible. Remind the patient how much he owes, and ask how the patient would like to handle the payment. The patient will often reveal information as to what is going on and give you a sense for whether or not he will need a payment plan. While plans will vary pending your office policy, Stevyn suggests (depending on the balance) setting up a payment plan that has the balance paid off within three to six months. The payment plan should also be in writing in order to have the patient committed to paying it off.

Nancy points out that the rapport you establish on the first visit or call should extend through any communication sent during or after treatment. For example, include a personal note when you send out the patient statements; it doesn’t have to be lengthy, but the patient will take more notice of the statement. Stevyn recommends that your communication include the following:

  • Your name and phone number, in case the patient has a question
  • Whether the patient’s insurance has finished paying
  • Whether or how much of the balance is the patient’s responsibility
  • Information on how to pay, including, if possible, a website where the patient can make payments online or via a PayPal account
  • A space on the statement itself for credit card numbers
  • A self-addressed, stamped envelope
  • Most importantly, a large and clear payment due date and amount

Lastly, set reminders to follow up with the patient if there is no response after two or three statements. If you made contact with the patient when he initially came to your office, call the patient yourself. The patient knows you, so you should make the call! Take advantage of this personal connection to ask the patient how you can assist him in taking care of his bill. If he states he has a financial hardship, check your office policies to see if and how he would qualify.

For more information on how to improve your clinic’s billing and collections procedures, consider PTPN’s new in-service video series, Therapy Office Operations 101. It covers not only billing, but also such related topics as patient intake, CPT coding, Medicare and much more. For more information on all of our in-service presentations, available for purchase to both PTPN and non-PTPN members, visit the PTPN Online Learning Center at In addition, PTPN and PTPN Nexus members can get more information by downloading our “Best practices for the best practice” from our Practice Management page after logging in at

A special thanks to our contributors:

Nancy Rothenberg Nancy Rothenberg, Vice President of PTPN, has played a key role in the development of PTPN for more than 25 years, as it has expanded from its roots in California to 23 states. Nancy has authored a number of articles on contract management and physical therapy and has been published in such journals as Workspan, ADVANCE for Directors in Rehabilitation, Risk Management, The PPO Letter, and the Journal of Health Care Benefits.
Stevyn Voyles Stevyn Voyles is the COO and Vice President of Progressive Physical Therapy, a PTPN member with four locations in Southern California. She has been with Progressive PT for more than 20 years and has been working in health administration since 1984.

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