Patient 10-Day Collection Letter

October 24, 2008


[Patient’s Name]


[City, State, ZIP]


Dear [Name]:

Our records indicate that your account is overdue. This letter is notice that if we do not hear from you within ten (10) days from the date of this letter, your account will be sent to our outside collection agency.

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.

We are sorry to have to take this action, but expenses in the health care industry are such that we can no longer perform services without receiving adequate compensation.

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




[Office manager or collection clerk signature block]


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