Practice Profits and Problems

9 Costly Myths About Collecting Payment From Patients

Jeffrey J. Denning


UnCommon Sense 

In This Article


As office managers repeatedly tell us, everyone now knows it is illegal to call patients at work about their past-due accounts, and it is harassment to call them at night or on the weekends, too. So the best thing to do is to keep sending the collection letters and statements with colored stickers on them.

Funny thing about conventional wisdom: It is often wrong.

For some tough collection professionals, getting money out of deadbeats beats teeing off with a Callaway 4 wood for entertainment value, but most medical office workers regard the task as one to be avoided. And the result is a bloated accounts receivable.

Here are some of the common collection myths we hear in our consulting and workshop travels. If your collection results are not what they should be, some of this misguided thinking might be the cause.

Myth 1: Legal Restrictions Make Follow-up Risky

Our opening myths about harassing patients at home and at work are a good place to start. It is true that most states have a fair debt collection practices law that governs what is acceptable and what is not. It is also true that this law usually applies to folks in the business of debt collections, not medical practices.

Putting that aside, the laws are not really that restrictive. Things like calling people in the middle of the night to scream obscenities at them or sending goons to their homes or offices are not usually the kinds of things physicians want their employees doing anyway. Most state laws prohibit unreasonably harassing debtors, but we have never actually encountered that in more than 30 years of practice management consulting.

Telephoning people at work or at home is not harassment until they tell you to quit, and maybe not even then if you are reasonable about it. Of course, if personal calls will jeopardize their jobs, that will not help you collect your fees. And it certainly isn't your goal to make your patients lose their jobs. So listen carefully when talking to patients at work, and don't tell anyone else there the reason for the call or imply that it is a medical issue you're calling about, either.

Another legal risk frequently raised is the notion that there is a malpractice risk associated with collection follow-up. We have never actually heard a lawyer say doctors should not pursue just debts because the patient might retaliate, but that is what physicians and office managers say they hear.

Our advice: Put yourself ahead of your malpractice carrier when deciding what is best for your practice. If there was a poor medical result, tread cautiously about collecting your fee — writing it off is probably the prudent (and also the right) thing to do. But if not, don't submit to extortion, especially that self-imposed by fear of a lawsuit.