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Medical collections are costing doctors millions. Here are the secrets of why patients don't always pay their bills, from a real-life deadbeat.

With medical collections costing doctors millions upon millions of dollars in unpaid bills and collection fees, many people have just one question: Who are these people who are trying to stiff the doctors who delivered them from great physical pain (or the flu, hypochondria, not-so-white-teeth, or a nose that didn't look enough like Brad Pitt's)?

Well, I'm here to tell you who these people are, or at least some of them.

They're me.

Yes, I admit it: I left a dentist's bill unpaid for three months.

OK, so dentistry isn't technically considered 'medical,' but it's the same situation: a doctor left in the lurch.

Why did I do such a horrible thing, especially when I, a small businessperson myself, know how difficult unpaid debts can make cash flow, and how it could very easily make me persona non grata in that office?

Why Medical Collections Happen

Or, Possible Reasons for Me Being a Deadbeat

Here are reasons commonly advanced for why people like me might not pay a doctor's bill.

1. They don't have enough money, plain and simple. After all, if they couldn't afford insurance, they probably are going to have trouble with the bill.

2. They don't care about the poor doctors and either don't know about or don't care about the potential for damage to their own credit ratings.

3. They are chronically lazy, stupid, or just don't know what they're doing. OK, the terms used aren't quite that specific, but that's the general idea.

All of these possible reasons why a patient might not pay could be pretty discouraging for a practice looking to get the money it's owed. After all, there's not much even the best doctor can do about a patient's poverty, venality, or fecklessness.

But is there really so little hope for collecting on medical debt?

Why Medical Collection Isn't Necessarily So Hopeless

Or, The Real Reason I Didn't Pay My Dentist's Bill

I just signed and mailed a check for my outstanding dentist's bill. That just goes to show the situation isn't so hopeless after all, doesn't it? Here's at least one case of a healthcare practice getting its money back., and after three months at that

No, my financial situation did not improve dramatically, nor did my slothful ways correct themselves.

Wondering what the dentist did to make me pay? Plead? Cajole? Shame? Threaten to put the tartar back?

Actually, the dentist didn't do anything, and that's the problem.

Here's what happened: I remembered I had the bill to pay.

I had forgotten ever owing the dentist money. Since I wasn't expecting the dentist's bill, unlike all the bills that come every month, it got lost in a pile of credit card offers, appeals to help save trees being cut down to make paper, and news about really great products for writers. The follow-up letter reminding me to pay met a similar fate. It probably didn't help when I took a trip to Las Vegas and then threw away the junk mail en masse when I got back.

I finally remembered the bill when someone asked me to write an article about medical collections. Sure enough, the follow-up letter (though not the original bill) was there in the pile of newsletters and friendly reminders from various businesses to schedule this or that appointment.

The Moral of the Story

If you are a patient, make sure to check your mail for letters from the doctor's office. If you're running a healthcare practice, follow up with your patients who have outstanding invoices'a phone call is preferable, since it's less likely to get lost at the bottom of a pile of correspondence.

Don't have time for that? Worried about the legal issues of collection law compliance? Don't let that stop you. Go to a company that specializes in medical collections and accounts receivables management for healthcare practices.

It's not about "putting debts in collection" anymore. Many of these companies offer everything from sending out a few polite phone calls and letters to end-to-end accounts receivable management. None of this has to impact your patients' credit rating or cost you a fortune.

Your office can go back to healing people. Isn't that why you got into this business in the first place?