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Collection Letter Template 05

This letter is informing a patient that their medical account is overdue and they need to pay the outstanding balance or set up a payment plan within 15 days to avoid further collection action.

Uploaded by

Fatima Arsh
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30 views1 page

Collection Letter Template 05

This letter is informing a patient that their medical account is overdue and they need to pay the outstanding balance or set up a payment plan within 15 days to avoid further collection action.

Uploaded by

Fatima Arsh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Patient Collection Letter

Practice Name

Practice Address
(Billing Phone Number)

Date
Patient Name
Patient Address
Re: Patient Name
Account #:

Balance Due: $

Dear PATIENT,

This is to notify you that your account with us is delinquent. We have not received a response to the
statements that were sent to you. The patient balance noted above is the amount that is your responsibility
after your insurance company has made payments.

We must receive your payment within 15 days from the date of this letter, to avoid further collection action.

If you need assistance or have any questions, please call between the hours of 8 a.m. and 5 p.m. If you are
unable to pay this bill in full, please call and we can discuss setting up a payment plan.

Sincerely,

Patient Accounts

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