TFAM Patient Balance Guide
Do not schedule patients with an unresolved balance.
Before placing any patient on the schedule, verify their account balance. If a balance exists, resolve it first or route appropriately before confirming an appointment.
Balances > $100
If a patient’s balance exceeds $100 and they have not responded after three documented contact attempts, the upcoming visit should be canceled. All outreach must be documented in Quick Notes.
Contact protocol (three attempts):
- Attempt 1: Notify the patient of the balance and request payment or a plan before their next appointment.
- Attempt 2: Follow-up reminder
- Attempt 3: Final request stating the appointment will be canceled if no response.
All attempts must be documented in Quick Notes.
Payment plans
Staff may offer a payment plan for up to 3 months. Any arrangement extending beyond 3 months requires approval from Britni or Scott. For requests involving hardship or longer plans, route to Scott.
Accounts eligible for collections
Patients with an unpaid balance greater than 60 days may be sent to collections. When this occurs, their account will be updated with an alert, and their patient category will be changed to indicate In Collections.
Exceptions and clinical considerations
If a provider authorizes a temporary exception for clinical necessity, document the reason and timeframe in Quick Notes and notify scheduling.
TFAM Balance Protocol — Quick Reference Table
| Topic | Policy | Actions Required |
|---|---|---|
| Scheduling With a Balance | Patients may not be scheduled if they have any unresolved balance. | Verify balance before scheduling. Resolve or route issue before placing on the schedule. |
| Balances > $100 (Unresponsive Patients) | If balance exceeds $100 and patient has not responded after 3 documented contact attempts, cancel the visit. | Document all outreach attempts in Quick Notes. Cancel appointment after the 3rd attempt if no response. |
| Contact Attempts (3-Step Protocol) | Patients must receive three attempts before cancellation. | Attempt 1: Notify of balance and request payment/plan. Attempt 2: Follow-up reminder. Attempt 3: Final notice stating appointment will be canceled if no response. |
| Payment Plans | Standard payment plans may extend up to 3 months. Plans longer than 3 months require Scott’s approval. | Offer ≤3-month plan. Route to Britni for hardship cases or requests beyond 3 months. |
| Accounts > 60 Days Unpaid (Collections) | Balances over 60 days may be turned over to collections. | Add alert and update patient category to “In Collections.” |
| Provider-Approved Exceptions | Providers may make case-by-case exceptions for clinical necessity. | Document the rationale and timeframe in Quick Notes. Notify scheduling. |