Before referring a patient balance to a collection agency, verify that insurance processing and payment posting are complete, the balance is accurate and supported, prior payments and disputes are reconciled, and the practice’s notice and referral policies have been followed. Confirm legal requirements with qualified counsel.
A practice should distinguish an estimate from the patient responsibility established after the claim is processed. Before requesting payment, reconcile the payer’s adjudication and any contractual adjustments, then communicate the balance and payment options clearly under the practice’s policies and applicable rules.
A therapy EMR can prepare and submit a clean claim, but it does not finish the revenue cycle. A billing owner still needs to resolve payer responses, underpayments, secondary claims, patient balances, and recurring workflow failures.