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May 18

The Four Types of Payers

Taking the “One Size Fits All” Model Out of Patient Collections

We at TSI (formerly known as Transworld Systems Inc.) believe that the traditional “one size fits all” approach that most collection agencies offer is not appropriate in today’s healthcare environment.  Patients with an outstanding balance can have different reasons for why they haven’t yet paid and should not all be treated the exact same way.  Some patients haven’t paid due to financial reasons because their deductibles are higher and they don’t have the funds to pay their balance and may need more time and/or a payment plan.  Others have the funds, but don’t understand their insurance policy and want to make sure the bill is correct before they pay it (but can’t find the time to call the billing office).  Others look at their EOB and see what their carrier paid and feel that the provider was already sufficiently compensated for the amount of time they spent with the patient, regardless of whether they can afford their portion or not.

We find that practices do a “balancing act” between being aggressive enough to get paid without being so aggressive that their patients take their business elsewhere.  Some spend a great deal of time and money following up on past-due accounts while others don’t have the resources to work their accounts and either hold on to them too long and continue to send statements, or send them to traditional collections early and forfeit future revenue from those patients who won’t return.

We have determined that there are 4 types of payers and feel that it’s not appropriate to treat them all the same way.


  1. Reliable
  2. Distracted
  3. Disrespectful
  4. Professional Debtors

Why They Pay

  1. Statement
  2. Reminders
  3. Third Party Impact of Soft Collections
  4. Intensive Professional Collections
  1. Reliable patients are those that pay on the first statement within 30 days
  2. Distracted patients have good intentions of paying their bills, but they are busy and distracted and don’t always pay on time. Reminders are usually sufficient to get their balances resolved.
  3. Disrespectful Debtors are trying to see what they can get away with or feel that they should have the right to decide what the provider deserves to be paid. They won’t respond to the practice’s “first party” bills, calls and letters but often respond to a third party collector once they realize the consequences of not paying their bills.
  4. Professional debtors are likely in collections already with other creditors because this is how they live their lives. They never had any intention of paying for services from the moment they walked in the door and need to be in the hands of Professional collectors before too much time/money is spent chasing them.

Transworld Systems offers tools which are integrated into MicroMD which can help you identify which type of patient you’re dealing with and then communicate with them in an appropriate manner and at a reasonable price.  We allow the practice to retain control over the type of communication that is being used on a particular patient since there are those that the practice is willing to continue to serve in the future (as long as they pay) and those that the practice finds disruptive and prefers to sever their relationship from.

If you’re using an agency that treats all patients in the same manner where you can’t control the level of intensity of their efforts, why not have a look at Transworld Systems?  It doesn’t hurt to get a 2nd opinion!

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1 Comment

  1. […] Cooper, K. (2017). The four types of payers.  […]

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