Patient copays

How to discuss co-payments with medically insured patients

Patients who have medical aid want to avoid co-payments wherever possible & understandably so. But with medical professionals operating within medical aid limits, patient co-pays are a reality that we all have to face. How you decide to handle collecting co-payments at your practice can make a significant difference to your revenue & patient loyalty. 

Why is it becoming more difficult to collect from patients?

There are numerous reasons why co-pays are becoming more difficult to collect. A declining economy, rising unemployment & interest rates, sharp increases in the cost of living & so on. Some of these factors are within your control & others not. But by optimising what you can control, you can mitigate some of your risk of accumulating crippling bad debt. To find out what you can do to improve your chances of payment, click here.

Dealing with patients who don’t pay

Patients who don’t pay their co-payments generally fall into one of two categories: 1. Patients don’t understand why they need to make a co-payment & 2. Patients who simply can’t afford to pay.  

1. Patients who don’t understand why they need to make a co-payment 

A lot of patients assume that they aren’t responsible for any medical bills outside of their monthly premium to the medical aid. In fact, many patients don’t truly understand their plan coverage & unfortunately, it’s your practice staff who have to explain the what & why of co-pays. It’s critical that staff are able to explain the reason for co-pays clearly & professionally. Here is a FAQ guide about co-pays that can help staff have the discussion with patients. 

2. Patients who can’t pay 

It’s likely that your staff has had instances where patients claim that they can’t pay. Whether they ‘forgot their wallet at home’ or issue a confident ‘send me an email’ instruction – they are avoiding payment at the time of service. If you have patients who regularly avoid making their co-pay, your staff might want to ask for payment upfront, before their appointment. 

Then there are other scenarios where patients are really struggling to make ends meet. You will have to rely on your judgment (& payment policies) to determine their sincerity & potentially offer them a payment plan.

Speaking of payment policies, it’s a good idea to remind your patients of your practice payment policy. You can do this on invoices, at check-in, when their patient details are being authenticated & posted around your waiting room. Remember that co-pays are a grudge purchase for insured patients so a clear, concise policy that they (& your staff) can refer to is a good way to ensure patients know what their responsibilities are. For more about what to include in your patient payment policy, click here

When patients get angry

Patients who lose their temper are likely experiencing any combination of surprise, embarrassment &/or confusion. Prepare your staff to communicate with angry patients calmly & courteously. Here are a few tips to help them do that: 

  • Listen first, resolve second 

Even if your staff know exactly what to do to offer the patient a solution, give the patient an opportunity to express their concerns & frustrations. Acknowledging & showing empathy for their situation is a powerful way to take the sting out of a heated discussion. Remind your staff to exercise patience, listen & avoid matching the patient’s anger with their own. 

  • Don’t take it personally 

Angry patients can get personal. Bear in mind that even if a patient is directing their frustration at a staff member, it’s coming from a place of fear or anxiety in combination with illness. Show respect to gently remind them to do the same. 

  • A little reassurance goes a long way 

Once a patient has said their say & calmed down, your staff should go about reassuring them that the issue can be resolved. If the problem can’t be resolved immediately, assure the patient that they will follow up & stay in communication about the progress of resolution. 

How many times has a customer service agent told you they will follow up & don’t?

If your staff have promised to follow up, they must do so. Following up is crucial to keeping professional integrity intact. Ensure that your staff build & maintain your patient’s trust by following up, every time. 


It’s never a pleasure to ask a patient for a co-pay, but it’s a reality if you want to ensure the financial health of your practice. To find out how Healthbridge’s system can help improve your patient collection processes, click here.


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