What to do if a patient refuses to pay a copay?
Asked by: Mr. Layne Kohler DVM | Last update: November 26, 2025Score: 4.4/5 (36 votes)
What do you do if a patient refuses to pay?
If after all these efforts, the patient still doesn't pay, the physician should send the bill to collections and dismiss the patient via a certified letter, requesting a return receipt. Dr. Fuller notes that physicians should provide dismissed patients with at least one month of time to find new medical care.
Is it legal to not charge a copay?
Co-pays can be burdensome for patients. But the government views them as an important part of Medicare. As a result, routine copay waiver is illegal and results in criminal and civil penalties.
How would you handle a situation where a patient cannot pay their co-pay at their time of visit?
Collect as much of that as possible before, or just after, medical services are provided. Provide a number of payment options to make it easy for patients to pay. Establish an effective program to collect amounts that patients cannot pay at the time of service. Monitor the success of collection efforts[1]
What if you can't pay your copay?
Provider Policy: The healthcare provider's policy may vary. They may allow you to receive the necessary medical treatment or prescription medication, even if you can't pay the copayment immediately. In such cases, they might bill you later for the copayment amount.
Barriers to Patient Access: Co-Pay Accumulator Adjustment Programs
How to get patients to pay their copays?
- Focus on Payment at Time of Service. ...
- Consider a Patient Responsibility Form. ...
- Double Down Staff Training. ...
- Leverage Technology to Make Payments More Convenient. ...
- Help Patients Improve Their Health Insurance Literacy.
Can a doctor refuse to see a patient for non-payment?
Some medical providers may consider refusing to treat because of the patient's inability to pay for treatment. Generally, in non-emergency situations, this is allowed. A private internist, for example, might refuse to schedule a patient's appointment if that patient has unpaid medical bills.
How would you deal with a client who was refusing to pay?
- Follow up immediately. ...
- Call them or schedule a meeting. ...
- Send a debt collection letter. ...
- Hire a collection agency. ...
- Consider letting it go. ...
- Research your new prospects. ...
- Be clear with your payment policies. ...
- Send invoices immediately and schedule reminders.
Does a physician have a duty to treat a patient who is unable to pay?
Right to Medical Treatment in Emergencies
Under EMTALA, all hospitals that participate in Medicare and their physicians are duty bound to stabilize and provide medical screening examinations for each patient who comes to the facility for emergency care, regardless of the patient's ability to pay.
Do I have to pay my copay upfront at urgent care?
You can be required to pay upfront for services at an urgent care center or receive the bill to pay at a later date. More importantly, urgent care centers have discounted self-pay rates for patients who pay cash for their medical services.
Are you required to pay copay?
Not all health plans have copays. It's important to look through the plan enrollment materials to find out if a plan requires copays. Here are some common medical services that may require a copay: Office visit to see a doctor or specialist.
Why the physician is not allowed to waive a co pay for a patient?
Providers sometimes waive patients' cost-sharing amounts (e.g., copays or deductibles) as an accommodation to the patient, professional courtesy, employee benefit, and/or a marketing ploy; however, doing so may violate fraud and abuse laws and/or payor contracts.
Can you write off patient responsibility?
It is not ok to bill insurance and then write off the patient balance. You are then in breach of your insurance contracts.
What is the very first thing you should do if a patient refuses treatment?
Is patient responsible for denied charges?
Most insurance companies have time limits to file a claim. If the healthcare consumer claim was denied for this reason, the consumer should not pay the bill. It is the responsibility of the healthcare provider.
Is it ethical to stop treatment if the patient is not able to pay?
Legal and Ethical Considerations
The concepts of beneficence and nonmaleficence are the embedded in the clinician-patient relationship. Delinquent patients can be discharged except in emergencies, although clinicians are responsible for the treatment of patients until other medical help is available to them.
What to do if a patient doesn't pay?
If, despite gentle reminders and special efforts to collect amounts due, a patient still refuses to cooperate, it may be time to discharge him or her.
What is an EMTALA violation?
What are the provisions of EMTALA? Physicians can get penalized for refusing to provide necessary stabilizing care for an individual presenting with an emergency medical condition or facilitating an appropriate transfer of that individual if the hospital does not have the capacity to stabilize the emergency condition.
Can a doctor be sued for not treating a patient?
Doctors are required to provide ongoing care once a doctor–patient relationship has been established. Suppose your condition requires follow-up. If your doctor doesn't take the necessary steps, they may be liable for medical malpractice if their lack of care causes injury or death.
Can I sue a client for not paying?
Sometimes invoices are past due 30 days, 60 days, or even 90 days, and they've not been paid. Perhaps you've sent multiple invoices, followed up by both phone and email, and you're still not paid. You do have the option to sue for non-payment, but sometimes that needs to be a last resort option.
What to say when someone refuses to pay?
Dear [Name], According to our records, your payment for invoice [Invoice Number] in the amount of [Amount Owed] due on [Invoice Due Date] is now two weeks overdue. Since we are not aware of any outstanding issues or reasons for non-payment, we ask you to make the payment as soon as possible.
What to do if a client walks out without paying?
Let the customer know that you mean business by setting a firm deadline for payment. Make it known that if the bill remains unpaid beyond this deadline, there will be consequences – such as suspending further services or taking legal action if necessary. Being firm doesn't mean being rude.
What is medical gaslighting?
Medical gaslighting describes when health care professionals seem to invalidate or ignore your concerns. It can be linked to missed diagnoses, delayed treatment, and poor health outcomes. It might damage your trust in the health care system and make you less likely to seek care.
Can a patient be dismissed for non-payment?
Severing a relationship with a patient is often a difficult decision and can lead to difficult conversations. Physicians may decide to dismiss a patient for a variety of reasons such as nonpayment, non-compliance and/or inappropriate behavior.
What is patient abandonment?
California defines patient abandonment as terminating the relationship without written notice to the patient. By law, the patient must have enough time to find another physician. If they decline further treatment or consent to the termination, however, they cannot legally claim abandonment.