Most doctors that begin a new business don't have the foresight to realize that they might never collect every dollar they earn. Sure, you deserve to be paid, but sometimes the patient's circumstances have changed. In this economy, people are being laid off or bills have overwhelmed them. You're a nice doctor, so they might be tempted to put off paying the money they owe you.

When this happens, you have a few options.

1. You can send them kind notes of reminder
2. You can can send them to a collection agency
3. You can forgive the debt

Sending notes of reminder can let them know you understand their situation, but still need payment. This is often a successful approach.

When you opt to send them to a collection agency, you may be setting yourself up for an angry confrontation and possible litigation, as people tend to sue others they don't like. Collection agencies sometimes use bully tactics that reflect on your practice. They are also costly.

A third option is forgiving the debt. If you see a patient's account passing 180 days with no payment, you can assume the debt may never be paid.

One imaginative D.C. decided to send a letter to his patients informing them that he was extending a "Christmas in July"  and forgiving their full debt amount. He explained that he cared about their health and wished them well. He heard about his actions in various places throughout town, including Wal-Mart where a former patient shared her tearful gratefulness  He turned his loss into a great marketing moment!

With that said, he also implemented a pay in advance program for any "forgiven" patients. I guess what I'm saying is ... think outside of the box. Be prepared in advance for the possibility of not being paid.

Install a credit card processing system that will take debit, credit and company insurance cards. Ask for partial payment in advance. Have staff send bills promptly and be prepared for patients that can't pay! You don't want to come up short!