Collection Letter FINAL

September 11, 2014

If patient has already been send the Collection Letter 1 and Collection Letter 2 and no payment was received, send this letter out after the first statement is 90 days stale and provide them with notice that the account will be turned over to collections.

To download this form, click here: Collection Letter Final.doc


 

[Date]

 

[Patient’s Name]

[Address]

[City, State, ZIP]

 

Dear [Name]:

Our records indicate that your account is now 90 days past due. This letter is your final notice. If we do not hear from you within ten (10) days from the date of this letter, your account will be turned over to collection.

If you cannot pay the balance of your account now, we still want to work with you to set up a mutually agreeable payment arrangement; however, our cooperation is only available if you contact us with the next 10 days.

Please ask for me when you call. Thank you for your prompt attention to this matter.

 

Sincerely,

 

[Office manager or collection clerk signature block]


To download this form, click here: Collection Letter Final

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