How to Deal with Patients with Insurance Payment Problems

It’s inevitable for practices to come across patients with insurance payment problems every now and again. These can range from patients simply being confused about why they have to co-pay or don’t understand their explanation of benefits statement; to irate patients who refuse to pay or withhold payment that was mistakenly sent to them by their insurance company. When these situations arise, it’s important for your staff to know how to handle them properly as their actions or inaction can affect how the entire practice will be viewed. They also directly affect how efficiently your practice will get paid and consequently, your bottom line.

So how should you deal with patients in these types of situations?

  • Remain cordial and professional. In these instances patients are not only sick, they may feel insecure, frustrated and fearful which shows outwardly as anger directed towards staff. Make sure your staff are well aware of this and that they should not take these kinds of reactions personally. They must remain calm, cordial and professional, assuring the patient that they will do everything they can to resolve the matter.


  • Listen. When patients become irate, chances are they just need to blow off some steam before they can discuss things reasonably. Train your staff to listen to patients first and never interject while the patient is talking, as this can only make the patient more aggravated. Only after the patient has calmed down should staff start assuring the patient of a resolution, and providing the information that the patient needs.


  • If a patient refuses to pay, have staff calmly and clearly explain that the insurance company does not shoulder the total cost of care, and refusing to make co-payments would be a violation of their contract with their insurance company. If they say they can’t pay, inform them of the alternative payment options.


  • If the patient mistakenly receives payment from the insurance company and keeps it, you will have to inform the patient of this mistake and explain why he or she needs to surrender the payment to you. As an option, you could bill them for services rendered and tell them that they can use the insurance payment to pay the bill. If they continue to withhold payment, then that may be the time when you’ll need to involve collection agencies or file a lawsuit.


  • If the patient is out-of-network and may therefore have to shoulder most of the bill, make sure your staff are able to clearly explain to the patient your policies regarding out-of-network patient payments.


  • Insurance payment problems can be resolved easily as long as you know the right way of handling them. You can also make it easier on yourself and your staff by partnering with a reliable billing company like Park Medical Billing.


At Park Medical Billing, we employ the latest technology and proven methodologies to provide our clients with an impeccable medical billing service. With our help, your practice can achieve greater levels of efficiency and maximize your revenue.
Know more about our services. Give us a call today at 1-201-585-7306.

Share Posts

Share on facebook
Share on twitter
Share on linkedin
Share on pinterest
Share on email
Share on print


Leave a Reply

Your email address will not be published.

Recent Posts

Request Your Free Billing Consultation

How much can we improve your revenues? Click below to find out.