You may have noticed that your insurance clients have higher “cost-shares” – that is, higher deductibles and copayments – than in the past. This means clients are becoming increasingly responsible for more of the costs for your services.

Also, your clients lives are often busy and chaotic, which can lead to lost income due to missed or late-cancelled sessions.

For these reasons, staying on top of client collections is essential to your cash flow. Whether you are in-network or out-of-network with the client’s plan, having clear and consistent policies when it comes to collecting client balances is the key to minimizing income loss.

10 Tips to Collect Every Dollar Your Clients Owe

1. Collect upfront – every time. If you don’t collect the client balance at the time of service, you immediately reduce your chances of ever collecting it. This is especially important since clients often leave treatment unexpectedly – sometimes in anger, and you are left with an unpaid bill. If you are a network provider, this means figuring out and collecting the client’s portion of the fee in advance. If you are out -of-network, I HIGHLY recommend you collect in full from the client at each session, and don’t bill insurance on their behalf (see my article on this issue here).

2. Communicate expectations. Clearly communicate (verbally and in writing) what you expect from clients regarding payment. Inform them when scheduling the first appointment and IN WRITING how much they will need to pay, what forms of payment you accept, and that payments will be due at – or before – each session.

3. If you are a network provider, verify eligibility. Contact the client’s health plan BEFORE the first visit to verify coverage, copayments, claims address, deductible, etc. (for a complete list of the essential questions to ask when checking coverage, see the worksheet in my book). Not making this call may be the biggest cause of later claim rejections, since charges often go to a deductible, or the client doesn’t have the coverage she thought she had.

4. Submit insurance claims quickly. Getting the claim processed as soon as possible after the session will help you find out quickly if you collected the wrong amount.

5. Enforce your cancellation policy. Not doing this may be the #1 reason you are losing thousands of dollars each year (see my article on this click here).

6. Don’t let debt build. If a client with a balance asks for an appointment, say you are happy to schedule one once the bill has been paid. Explain you have this policy since debt can negatively impact the clinical work you are doing in therapy. Let them know all acceptable payment options.

7. Keep a credit card on file for ALL clients, and get a signed authorization that allows you to charge missed sessions or other balances owed. Collections may lose their sting when a credit card is used. Plus, you are more likely to be paid when a client is not required to take action to make the payment (as is required by Venmo or Zelle).

8. Consider allowing clients to make partial payments until the debt is paid off, but be wary of continuing to meet with them in the meantime.

9. Check all client charts at least monthly to identify and address overdue balances. Establish consistent collections policies, outlining when you will send reminder letters, e-mails, and voicemail messages attempting to collect, and what you will say in each. Collection requests should be no more than 30 days apart, and escalate in message tone from soft reminders to firm payment requests with clear deadlines of when payment is due.

10. The biggest obstacle to getting paid? Ourselves. We don’t check coverage, get busy, sloppy in our bookkeeping, don’t write down amounts owed for missed sessions, don’t notice overdue balances, and let balances slide without following up. Initiating good bookkeeping habits now can minimize lost income.