Have an employee print the encounter forms in advance and contact the patient concerning their past due balances and the expectation of payment at check-in. When the patient checks in for the appointment, the Front Office employee could place the superbill on the counter for the patient to see the amount and then asks how they wish to pay.
Although you can practice objection comebacks with the staff, I have found it is argumentative and leaves the door open for continued excuses. Instead consider using the Broken Record Technique. If the patient says they cannot pay (regardless of the reason), the employee is to advise the patient that if he/she is unable to pay the past due balance, that day's visit will have to be rescheduled. If the patient comes back with another excuse for not paying, the employee is to make the same statement in the same pleasant and caring tone of voice. By making the same statement to the patient each time, it lets the patient know that excuses will not change the inevitable. The employee does not have combat every excuse and the patient does not feel that the employee is arguing with him/her. It is rare that we have to reschedule the patient's visit.
And yes, always make sure that the patient has not come in for an urgent visit before they are rescheduled.
All physician offices need to change a culture of “service now, pay later.” It is tough in the beginning, but you can lead your patients into the change eventually.