Setting up a Payment Plan with Your Patients

June 13, 2012

Looking for a simple tool to create a payment plan for your patients? Here's one to download and use at your medical practice.

Practices are often faced with a patient, who is unable to pay for a service at the time of the visit, or at the time a procedure or test is to be scheduled.

In these situations, it would be helpful to set up a payment plan, with, basically, a promise to pay. Furthermore, it is recommended that you formalize this commitment with a handy form, such as the one I offer below.

The patient would be provided one copy and the practice would retain the other. Additionally, these promises to pay could be entered in your accounts receivable system. This will then alert you with reminders to process the credit cards or, if the commitment is to be paid by cash or check, to be sure to follow up with the patient who has not paid on time.

You can modify this suggested form to meet your preferences.

Download the form here as a Word document and here as a PDF file.

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