Getting patients to pay with the right EFT reference
How a practice gets patients to pay their accounts by EFT with a reference staff can match, and what to do with transfers nobody can identify.
By Achekam · · 5 min read · For Healthcare businesses in South Africa, Nigeria, Kenya
The bank statement arrives and the practice's bookkeeper starts on the transfers. Most are easy. Then come the others: a payment referenced "Dr appointment", one referenced "Mom", one with the patient's ID number, one from a company account with no reference at all, and three from parents paying for children who have a different surname. Each needs detective work, and while it waits, the patient's account still shows as overdue and the reminders keep going.
Unreferenced transfers are one of the quiet costs of running patient accounts. This article explains how to get patients to quote a reference you can match, how to record the payment once it arrives, and what to do with the ones nobody can place.
Why unreferenced transfers pile up
Patients are not careless; they are rarely told what to quote. The practice's banking details are on a sign at reception or on last year's letterhead, with no mention of a reference, and the patient's banking app asks for one at the last moment. They type whatever comes to mind.
The fix is to give every patient the same instruction, in every place they might pay from: quote your invoice number. An invoice number is unique, it is on every invoice, and it points to one account without anyone needing a patient's ID number in a bank reference.
Bank details and a reference on the pay page
Every issued invoice gets the next number in your sequence, and the number format is set in Settings. Choose a format that is easy to read aloud and type into a banking app.
An issued invoice can also have a payment link, copied or e-mailed with the invoice. The patient opens it on a public page with the practice's name and branding. That pay page can show the practice's bank details and a payment reference, so a patient who prefers EFT has the right account and the right reference in front of them at the moment they pay. Each bank account takes one currency, so make sure the account shown matches the currency of the invoice.
A link lasts 14 days by default, and there is no link for a draft or voided invoice. For an account that runs longer, send a fresh link with the next statement.
The reference on invoices and statements
Repeat the instruction everywhere the patient sees a balance:
- On the invoice e-mail: "Please pay by EFT using your invoice number as the reference, or use the link."
- On statements: a customer statement of account is produced as a PDF that can be e-mailed, and the screen says whether it was sent. The covering e-mail should give the bank details and ask the patient to quote the invoice numbers they are paying.
- At reception: a printed card with the bank details and "Reference: your invoice number".
Patients paying for a child should quote the child's invoice number, not their own name. Say so on the card; it saves most of the surname puzzles.
Marking a payment received once it shows in the bank
An EFT is paid when it shows on the practice's bank statement, not when the patient says it was sent. A staff member marks the payment received once it appears on the statement.
Two steps, and the second is the one practices miss:
- Reconcile the bank. Import statements as PDF, CSV, Excel, OFX, QIF, MT940 or CAMT.053; each import is checked so the opening balance plus movements equals the closing balance. Bank lines are matched by suggestion and a person accepts each match.
- Record it on the patient's account. Matching a bank receipt to a customer invoice does not record the payment on the invoice; it must also be recorded in receivables. Record the payment against the invoice the reference names, or spread it across the patient's invoices. A part payment leaves the invoice part-paid, and any extra is held on the patient's account.
Skip the second step and the patient keeps getting reminders for an invoice they paid, which is how good relationships with patients go sour.
In Kenya, practices using an M-Pesa paybill or till have a head start: once registered, a payment that quotes an open shilling invoice number as the account number is receipted automatically, while any other payment waits in a list for a person to allocate. The same instruction, quote your invoice number, does the work there too.
Payments nobody can identify
Some transfers will still arrive with no usable reference. Handle them the same way every time:
- Look for clues. The payer's name on the bank line, the amount (does it match an open invoice exactly?), and the date against recent visits.
- Ask. If a likely patient emerges, phone them to confirm before allocating.
- Do not guess. If nobody can be identified, do not attach the payment to the nearest-looking account. Leave it unallocated and keep a short list of unidentified receipts with date and amount.
- Review the list monthly. Patients often surface when a reminder reaches them for something they believe they paid. Check the list before replying.
A worked example in words: a transfer arrives referenced only with a first name. The amount matches one open invoice exactly, for a patient with that first name seen the week before. The bookkeeper phones the patient, who confirms it, records the payment against that invoice, and adds a note. The patient's next statement shows the account settled.
For patients paying at the counter by transfer, the till has its own discipline; EFT payments at the service counter shows how it works. Statements and reminders for patient accounts are covered in patient account statements, and balances left after a scheme pays part in collecting the medical aid shortfall.
In Nigeria, many patient transfers travel over NIP, the interbank transfer service run by NIBSS. NIBSS explains how NIP works as the real-time account-to-account transfer service across mobile, internet, USSD, POS and agent channels, with transaction status queries that help when a patient insists a payment went through.
One instruction, repeated everywhere, removes most of the detective work. Ask every patient to quote their invoice number, record every EFT on the account as well as in the bank, and keep an honest list of the payments you cannot place.
General guidance only, not advice on your own circumstances. Tax and payroll rules change: check the current position with the authority or your adviser.
