Debt prevention and management in general practice

Patient debt is a sensitive topic and can be very difficult for both the patient and the practice to talk about. Not only does it have financial implications for your business, but it also can create an access barrier if patients can't pay their debt prior to needing care.

Having a good process in place for managing and monitoring patient debt can prevent patients having large outstanding debts that are harder to pay off, and it empowers your admin team to be able to deal with these situations early.

Debt Management Policy

•        Have a policy outlining your expectations for payments and the processes for managing this. This should include processes to prevent large debts such as setting up a payment plan or upfront payments for some patients, as well as the process for managing the debts that have occurred.

•        The whole practice team should be aware of your Debt Management Policy so anyone can discuss this with the patient and be reassured that the practice is there to support the patient and provide them with options.

•        Consider appointing a Debt Champion to manage your process.

Debt Prevention

  • Inform patients of all payment options (AP’s, online banking, EFTPOS etc). Include these on your website, practice signage, at the bottom of invoices and reminder texts. Also include information about speaking privately to the practice manager about their situation and the options available.

  • Consider offering the option of patients paying weekly amounts to spread out the cost of consultations. Ensure you have a process to manage these payments and consider having a credit limit.

  • Have a process where patients that might need some support can be identified early. This information may come from your clinical team.

  • Have a process where the Debt Champion or Practice Manager can have a private conversation onsite or a phone call with the patient (away from the front desk). This ensures appropriate supports are put in place before the debt level is overwhelming and creates an access barrier.

  • Ensure the patients are aware of the fees when they are booking, particularly the cost of additional services such as minor procedures or double appointments. Include these on your website and reception area.

  • Include payment expectations in your enrolment process.

  • Check if the patient is eligible for a Community Services Card.

  • Ensure eligible clients are receiving a Disability Allowance.

  • Ensure staff are aware of instances in which the patient’s care may be covered by a WellSouth funded programme. 

Debt Management

  • Have a process for identifying increasing debt and managing it when it occurs. This needs to be done regularly and can be split between people within the team ie part of the process can be managed by a receptionist/administrator and other parts by the practice manager (e.g. when things need to be escalated).

  • Consider identifying a Champion. Debt collection is a special skill and a task that not everyone is comfortable with; consider who in the team is the best person to ensure it is done effectively, compassionately and respectfully.

  • Have a process for writing off small debts when a patient transfers out or becomes uncontactable. This may include writing off debt under a certain value but putting an alert of the file if the patient makes contact in the future or wishes to re-enrol.

  • Report the level of debt to the Business Owners or Leadership team regularly.

  • Include debt as an agenda item at staff meetings. Include any changes to process, things that staff need to be aware of, or any issues they would like to raise.

  • Read the patient notes before making phone calls to patients in debt. This gives you a clearer idea about what is going on for the patient, their living situation and what things you might be able to offer.

  • Formal debt collection through a third party is most likely a last resort as this service comes with a range of fees and charges, note that most debt collection agencies will only recover debts over a certain dollar amount. Have a process in place for using Debt Collectors, such as giving the patient a 7-day warning and ensuring they understand the impacts on their credit rating if they are sent to debt collection. 

More advice

We also recommend this webinar on Mana Enhancing Debt Management from Collaborative Aotearoa.