Key takeaways
- Post insurance payments and bill secondary coverage before billing the patient.
- Make the amount due, due date, and payment options easy to find.
- Collect known amounts at check in and send statements on a steady schedule.
As deductibles and coinsurance have grown, more of what a practice is owed comes from patients rather than payers. Patient balances are also some of the hardest to collect when the statement is confusing, late, or wrong. A clear process helps patients pay and reduces calls to the front desk.
Start with an accurate balance
A statement is only as good as the posting behind it. Before a balance goes to the patient, the insurance payment and adjustments should be posted correctly, and any secondary insurance should be billed. Sending a patient a bill that later changes damages trust and creates more work.
- Post ERA and EOB payments promptly and correctly.
- Apply contractual adjustments so the patient only sees what they owe.
- Bill secondary insurance before billing the patient.
- Hold statements when a claim is still under review or appeal.
Make the statement easy to read
- The date of service and the provider who saw the patient.
- What was billed, what insurance paid, and what was adjusted.
- The amount due, in large clear type, with a due date.
- Simple ways to pay, such as online, by phone, or by mail.
- A phone number to call with questions, and hours when someone will answer.
Send on a regular schedule
Choose a cycle and keep to it, for example a first statement once insurance has processed, then reminders at regular intervals. Consistency helps patients plan and keeps balances from aging quietly.
Collect at the time of service
The easiest balance to collect is the one collected at check in. When the front desk knows the copay and any remaining deductible from the eligibility check, it can collect what is due before the visit, in line with your financial policy.
Handle questions well
Most patient billing calls are about what insurance paid and why the patient owes the rest. Train whoever answers these calls to explain the EOB in plain language. Offer payment plans where your policy allows, and record each conversation.
Follow the rules
Patient billing is covered by federal and state rules, including rules on surprise billing, good faith estimates for self pay patients, and how collections are handled. Make sure your policies and statements follow current requirements.
A quick example
A practice gets many calls from patients confused by their bills. Reviewing the statement shows the amount due is hard to find and insurance adjustments are not shown. After a simple redesign that shows billed, paid by insurance, adjusted, and amount due in one clear block, with an online payment link, calls drop and balances are paid sooner.
Questions to ask your team
- How long after insurance pays does the patient receive a statement?
- What are the most common questions patients call about?
- Do we collect copays and known balances at check in?
Where Afiable helps
Afiable posts payments, reviews balances after posting, and supports patient statements and balance questions as agreed with your practice. Book a free audit and we will review how patient balances move through your practice today.
Questions practices ask
When should the first statement go out?
After the primary and any secondary insurance have processed, so the balance is final.
Should statements be paper or electronic?
Many practices offer both. Electronic statements with online payment are often faster, but some patients prefer paper.
This article is general information for practice owners and managers. Payer policies and regulations change, so confirm current rules with each payer before acting.