In most therapy practices, patients now owe a large share of what the practice is paid: deductibles, copays and coinsurance. The coordinator is the person who makes sure that money actually comes in, kindly and on time.
Before the first session
- Give the patient their estimate in writing (see “Insurance, benefits & authorizations”).
- Have them sign the financial policy, the cancellation policy and the card-on-file authorization.
- Save the card in the practice’s payment system. Never write card numbers down or keep them in email or notes.
At every session
- Collect the copay or estimated amount at check-in (or charge the card on file before a telehealth session, per policy).
- If the card declines, contact the patient the same day and ask for an updated card. Note it in the account.
- Never hold a session hostage at the door; follow the practice’s policy for who decides.
Statements
| When | What |
|---|---|
| After insurance pays | Post the patient balance and send the statement through the portal or email |
| 30 days | Friendly reminder |
| 60 days | Second statement and a call; offer a payment plan |
| 90 days | Final notice per the financial policy; practice decides next step |
Keep statements simple: date of service, what insurance paid, what the patient owes, how to pay. Patients who understand a statement pay it.
Payment plans
Offer only what the policy allows, confirm the terms in writing, and set up the automatic charges right away. Check every week that plan payments went through.
Posting patient payments
- Post every payment the same day, against the specific charges it covers.
- Record the method (card, cash, check, HSA card) and send a receipt.
- If the patient overpaid, flag the credit for a refund or for their next session, per policy. Don’t let credits sit.
- At the end of each day, the payments you posted should match the payment system’s deposit report.
Collections and small balances
Sending a patient to collections in a therapy practice is a serious step that can end the treatment relationship. It is always the owner’s or billing lead’s decision, never yours. Your job is to make sure it rarely gets that far.