Verify eligibility before every visit
Run eligibility (270/271 through your clearinghouse or PM) 1-2 days before the visit: active coverage, copay, remaining deductible, and whether you’re in-network for that specific plan. Most “patient owes more than expected” surprises are skipped eligibility checks.Estimate before you treat
Quote the patient’s share before the work: contracted rate minus what eligibility says remains on the deductible. For self-pay and uninsured patients, the No Surprises Act requires a written good-faith estimate, and patients can dispute bills that exceed it by $400+. Build the GFE into scheduling for self-pay patients rather than treating it as paperwork.Collect at the point of care
The rules that work: copays before the visit, not after. Card-on-file with signed authorization for balances that adjudicate later (POS setup). Deposits for high-ticket elective work. Payment plans offered proactively at checkout, or third-party patient financing for large cases.Bill fast, escalate gently
Statement within a week of the ERA posting, not month-end. Text or email with a payment link outperforms paper. A simple ladder: statement, reminder at 30 days, call at 60, decision at 90 (settle, plan, or small-balance write-off). Collections agencies recover little and cost goodwill; use them as policy for large balances, not reflexively.Waiving copays and deductibles routinely is not a kindness, it’s a compliance
problem (insurance fraud with commercial payers, kickback exposure with
federal ones). Hardship discounts need a documented policy applied
consistently.