Are you forgetting to collect copays?
Co-pays
It’s important to collect all co-pays upfront. Remember there is no better time to collect them, than when the patient is there right infront of you. In order to collect money, the person asking for it has to have some of the following traits:
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Confidence.
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Knowledge about the services and goods your office offers.
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Assurance to the patient that your office knows the ins-and-outs of how insurances work.
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A friendly smile that will bring confidence to your patients, assuring them that they have made the right choice to come to your office.
In most cases when co-pays are not being collected, it is usually common to shrug it off as if to say, “well we can always send out a bill”.
Sending a patient bill costs your office administrative time, postage and supplies. The average cost of generating a bill can be up-to $5 dollars. Remember to also factor in possible future collection attempts through phone calls and correspondence if the bill goes unpaid. Each month the bill is unpaid your chances of collecting on it, are greatly reduced.
Make sure you learn to simplify and reduce your administrative costs by collecting all co-pays upfront. An office that collects all co-pays upfront has the potential to be more financially healthy than those that don’t.
Take the time to educate your staff in learning about the goods and services your patients receive; this way everyone is completely confident when asking patients for any money due.
-Jesus C. Vazquez, PMAC
The American Society of Podiatric Medical Assistant's Blog 
It is also important to remember that the insurance contract the patient agrees to and pays premiums for REQUIRES payment of the co-pay for the services rendered.
Continued writeoffs of copayments can also be viewed as contractual violations on the part of your practice-remember also that your ultimate payment is reduced based on the fact that you are collecting that copayment up front.
I believe that most people come prepared and expect to pay their copays up-front.
If you do not get the copays at visits, it is always harder to collect them later. I find this especially true of Medical Assistant payments, because of the small amounts owed, there is usually no bill sent out. So what do you do with all of these small amounts on your accounts receivable.
In our office any balance due under $5 dollars is left to be paid until the patient’s next appointment, sometimes the cost of printing and mailing a bill is greater than the balance due. Ofcourse, this is a policy that works for our office, you may consider one that could work for your practice.
If a copay is not paid because we forgot to collect it, we either send a bill right away or we make a note to collect it at their follow up appointment.
Does anyone else have other tips or suggestions?
All front staff in our office are trained to check insurance on all patient before they are seen, so that we may collect the correct copayment up front. We also then know the exact amount to collect on deductibles, co-ins, etc. when the patient “leaves”. We also let the patients know before they see the doctor if they will have to pay anything (deductible, percentage & approx. cost) before they see the doctor. There are times when the insurance company gives us the incorrect information but our total outgoing billing is about 50 statements a month. Very few if any go to collections. Anything under $2 is sent one statement to meet guidelines for collections and then is collected at the next visit. All others are given two statements then an option letter, then a final notice and if no pay still, turned over to collections. I very seldom send to collections. The final notice which gives the name and address of the collection company usually does the trick.