QUESTION:  How should I handle a patient whose check has been returned unpaid by the bank?

ANSWER:  Everyone makes mistakes from time to time or has an unexpected shortfall in their checking account balance.  This is especially true on family accounts where two people are writing checks and may not always keep each other informed.  Such instances should be handled very carefully. 

A returned check is an inconvenience for both you and the patient and should not be blown out of proportion.  Here are some steps to consider when dealing with this situation:

• A returned check is always an embarrassment to the check writer. Don't make more out of it than it usually is, an unexpected mistake.

• You will want to establish a returned check policy and make sure that all patients know what that policy is.  You will probably want to post it at your payment window.

• Your senior staff person should make the first contact by phone and let the patient know what has happened.  Always talk directly to the person who wrote the check, not their wife, husband or other family member.  Let the patient know you are calling out of concern for them since bank charges will be assessed for every such check and they may not even know they are overdrawn.

• On the first encounter give the patient the opportunity to indicate how they want to handle the situation. 

• If they do not come forward with an offer to drop by with cash, a credit card or a new check, offer to take a credit card over the phone that is convenient to both parties. 

• Always indicate that you are keeping this matter confidential.  Be cordial and polite and never use a "collections" tone of voice or imply any sanction or enforcement action. 

• For repeat situations, a frank talk about payment options is in order.  They may need your help in saving you both considerable expense and inconvenience.  Suggest cash or credit card payments, or, if this is not possible coordinate future check payments to make sure they will be covered by the patient's current balance.

• The doctor should not get involved unless the situation occurs repeatedly, or some issue related to the care the patient is receiving or some other practice issue is involved.

• Checks returned for non-sufficient funds (NSF) are a common and easily dealt with situation.  Checks on which the patient has stopped payment are a different situation entirely.  Here, the doctor needs to immediately contact the patient and resolve any and all outstanding questions in as positive a manner as possible.  A stop payment situation is a signal of trouble and requires extra careful handling.

• Remember, how you approach all collections can spill over into your whole practice if you are heavy handed or too aggressive regardless of the reality of the situation.  Especially in close knit communities your reputation can be impacted by collections in ways you might not anticipate.  So caution is always the best policy.