If you’ve spent any length of time in a rehab therapy clinic’s front office, you’ve probably witnessed—or participated in—some uncomfortable conversations concerning a patient’s inability to make a payment. While these frank discussions are never fun, if your clinic doesn’t have a written payment policy, you’re gonna have a bad time. Fortunately, you can avoid those “well, this is awkward” moments with this guide to developing a foolproof policy for collecting patient balances.

Breaking Bad Habits: The Modern PT’s Formula for Success - Regular BannerBreaking Bad Habits: The Modern PT’s Formula for Success - Small Banner

1. Contact New Patients Before the First Visit

The initial “make or break” moment in any relationship is the first impression, and the relationship between a clinic and its patients is no exception. And in this case, it’s completely okay for you to make the first move. Contacting new patients—whether it be via email or over the phone—is a good way to break the ice, so to speak, and to let patients know that they should be prepared to uphold their financial responsibility at the time of the appointment. This is also a perfect opportunity to get a head-start on collecting a patient’s insurance and demographic information (one less thing to worry about on the day of the visit).

2. Collect at the Time of Service

These days, you’d be hard-pressed to find a clinic that doesn’t require patient payments to be collected at the time services are rendered. And really, there’s no shame in it. After all, when patients handle their financial responsibility upfront—at every visit—it prevents the amount owed from accumulating and becoming overwhelming. Let’s face it: generally speaking, insurance companies expect patients to pay their copays, and they expect practices to collect them—and it’s super important to make sure your patients are aware of those expectations.

Of course, that doesn’t mean you can’t work with a patient to create a payment plan that works with his or her budget. And if you decide to do so, make an effort to firm up the details of that plan before the patient begins treatment.

3. Cover Your Critical Payment Policy Bases

Provide a List of Your In-Network Insurances

As a patient, there are few things more anxiety-inducing than finding out your chosen provider is out-of-network after you receive an outrageous bill. And as a provider, you can help patients avoid that sticker shock by presenting all new clients with a list of accepted insurance payers. In addition to publishing this list within your payment policy, you may also want to include it on your practice’s website; that way, it’s available to prospective patients as well. Finally, I’d recommend training your front office staff to confirm in-network carriers when patients call to set up their initial visit.

It’s also important that patients understand they will be responsible for any leftover costs. So, make sure you highlight that responsibility within your practice’s payment policy.

Include a Refund Policy

Does your practice sell cold packs, tape, or maybe some of those amazing foam pillows? Then having a refund policy within your overarching payment policy is must. Refund policy timeframes can range anywhere from one week to 60 days after the date of purchase, depending on the item. You should also check with your individual vendors to see what their return policies are, as this could factor into your own guidelines.

Address Cancellations and Missed Appointments

Life has a way of, well, getting in the way—car problems, long-running soccer/dance/fencing practices, dogs getting into the trash can (again). And sometimes, this means appointments get put on the back burner. However, frequent cancellations and missed appointments can add up—and have a significant impact on your business. As such, it’s wise to include a cancellation/no-show section in your payment policy. Specifically, I would recommend:

  • Setting a specific timeframe for patients to reach out and notify you ahead of time (24 hours is standard).
  • Clearly stating the consequences of not notifying your clinic within the given timeframe.
  • For late cancels and no-shows, charging the amount (or a portion of the amount) you would have billed for the appointment.

Download the PT Patient's Guide to Understanding Insurance

Patients confused about their insurance coverage? Avoid uncomfortable conversations later. Enter your email address below and give them the PT Patient’s Guide to Understanding Insurance.

Please enable JavaScript to submit form.

4. Overcome Objections

Even with the most meticulous and well-written of payment policies, there will certainly still be instances in which patients can’t—or claim they can’t—provide payment. When this happens, it’s important to remain empathetic, but firm. Have a script handy (like these ones from the American Medical Association) for your front office staff to use when these situations arise. If you don’t accept all credit cards, you may also want to make a note of the nearest ATM. And if the patient truly cannot make a payment on a particular date of service, it’s vital that you require him or her to pay in full on or before the date of his or her next appointment.

5. Obtain Patient Acknowledgement

All of that being said, the perfect policy is meaningless if the patient never sees it. So, be sure to provide a copy of the policy to all new patients, along with any other forms that require patient completion and signature. When patients sign and acknowledge your payment policy, it covers both of you in the event of any “surprises.” It’s also smart to post additional signage at the front desk reminding patients that you require payment on the date services are rendered.


Most folks don’t get into health care because they love collecting copayments and outstanding patient balances. But, it doesn’t have to be the elephant in the room. Having a solid payment procedure—and keeping your patients in the know about your policies—not only empowers your front office staff, but also makes this seemingly awkward facet of private practice a no-biggie. Have you implemented a payment policy in your practice? What are some elements you’ve included to make it a success? Share your thoughts in the comment section below.

  • Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans Image

    webinarFeb 23, 2017

    Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans

    Copayments, coinsurances, unresolved balances—oh my! Any one of these can cause headaches for healthcare providers, but as healthcare reform efforts shift more and more financial burden to insurance beneficiaries, today’s practitioners are increasingly facing all three. And these challenges are not only hurting their patient acquisition and retention rates, but also their bottom lines. Tired of spending time verifying benefits only to lose those patients to copay sticker shock? Stuck in a constant cycle of pursuing past-due …

  • Down with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid Image

    webinarApr 19, 2017

    Down with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid

    One denied claim might not sound off your billing alarm bells—but in reality, it should. That’s because—as with faulty plumbing—one leak often indicates a much larger issue. And all too often, rehab therapy practices fail to act quickly enough—and soon find themselves wading in a flood of lost revenue. But there are simple, proven, and affordable ways to not only plug your billing holes, but also reinforce your whole system so you’re less likely to bust a …

  • 4 Major RCM Killers (and How to Fend Them Off) Image

    articleMay 17, 2017 | 6 min. read

    4 Major RCM Killers (and How to Fend Them Off)

    As the old adage goes, your best offense is a good defense—and no one knows that better than the folks responsible for revenue cycle management (RCM). When it comes to rehab therapy billing, getting dinged with claim denials might seem inevitable. But, taking steps to avoid the following four RCM killers will help you shield your practice from taking a critical hit. 1. Ineffective (or Non-Existent) Payment Policy Money talks , and when we’re talking money, there’s …

  • Founder Letter: 3 Ways Your Practice is Losing Money Image

    articleMay 5, 2016 | 7 min. read

    Founder Letter: 3 Ways Your Practice is Losing Money

    Much like the patients you treat, your practice can appear healthy on the outside despite significant internal issues. And when those issues are money-related, the consequences can be deadly. If your practice already is in the red, you know you’ve got some pretty serious cash flow problems. But even if you’re in the black every month, you may still be washing dollars down the drain. While there are myriad ways your practice might inadvertently be losing revenue, …

  • PT Billing Tips from the Trenches Image

    articleMay 22, 2017 | 6 min. read

    PT Billing Tips from the Trenches

    It’s hard out here for a biller—between dodging denials, hunting past-due balances, and navigating the ever-changing compliance climate, keeping a rehab therapy practice’s billing processes in tip-top shape is no simple feat. The heat is definitely on when a good portion of your company’s cash flow falls squarely on your shoulders—but you don’t have to go it alone. In fact, we’ve rounded up several therapy billing gurus who were happy to lend their expertise and spill some …

  • The Dos and Don’ts of Working With Insurance Companies Image

    articleJul 7, 2017 | 6 min. read

    The Dos and Don’ts of Working With Insurance Companies

    In 2016, Forbes reported that doctors spend more than 66% of their time on paperwork. And a good deal of that paper-pushing is insurance-related. There’s no denying that working with insurance companies is a challenging—yet required—part of running a rehab therapy clinic. One of the biggest hurdles in this professional relationship is negotiating contracts. Most medical professionals have at least heard a story of a nightmare negotiation that led to nothing but frustration. Ultimately, insurance companies usually …

  • What's the Right Payer Mix for Your Practice? Image

    articleJul 17, 2018 | 6 min. read

    What's the Right Payer Mix for Your Practice?

    Insurance payments for healthcare services have been declining for a while now , which means providers in all disciplines are looking for ways to optimize their payer mix in order to maximize their revenue. If you haven’t yet calculated the cost of providing your services—and compared that number to the payments you’re receiving to ensure you’re actually making enough money to not only cover those costs, but also turn a profit—then you should. But the question remains: …

  • Cashing In on Private Pay: The PT's Guide to Going Out-of-Network Image

    webinarJul 27, 2017

    Cashing In on Private Pay: The PT's Guide to Going Out-of-Network

    For many rehab therapists, submitting a claim to a third-party payer feels a lot like pulling the lever on a slot machine. You never know for sure what you’re gonna get—and most of the time, it’s less than you’d hoped for. With seemingly ever-increasing regulations—and constantly shrinking reimbursements—it’s no wonder so many PTs, OTs, and SLPs feel like the financial odds are stacked against them. [video://fast.wistia.net/embed/iframe/c49leax8yk] As a result, more and more rehab therapy providers are trying …

  • Coding Faux Pas: 5 Common Rehab Therapy Billing Mistakes Image

    articleMay 9, 2017 | 7 min. read

    Coding Faux Pas: 5 Common Rehab Therapy Billing Mistakes

    As the old saying goes, “To err is human.” But when human error stands between you and timely reimbursements, it’s difficult to remain philosophical. From missing GP modifiers to miscalculated coding units, here are five common billing mistakes that keep rehab therapists from getting paid. 1. Omitted Modifiers Modifiers: Easily applied; even more easily overlooked. Therapy modifiers—including GP, GO, and GN—specify to the payer what kind of therapy service was provided (e.g., physical, occupational, or speech therapy). …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.