Statements and reminders for patient accounts
How a practice can follow up what patients owe with invoices, daily overdue reminders and monthly statements that go out without someone chasing each day.
By Achekam · · 5 min read · For Healthcare businesses in South Africa, Nigeria, Kenya
Every practice carries patients who owe something. The scheme paid part of the account and the patient owes the rest. A procedure was billed after the visit. A regular patient asked to settle at month-end. Each balance is small, but together they add up, and the person who is supposed to follow them up is usually the same person answering the phone and booking the next patient.
Chasing by hand tends to happen in bursts: a quiet afternoon, a stack of printouts, a round of awkward calls. Then the waiting room fills up and nothing happens for weeks. The fix is not more effort at reception. It is a routine that runs on its own and tells you what it did.
Turn the balance into a proper invoice
Follow-up only works if each amount owed is a real, numbered invoice in the practice's books, not a note in a diary.
In Achekam, an invoice starts as a draft that you can change or delete. Issuing it gives it the next number in your sequence and posts it to the ledger as an amount owed to you, with the sale and any output VAT. The default payment terms are 30 days.
Once issued, the invoice can be downloaded as a PDF on your letterhead or e-mailed straight to the patient. You can send it with a pay link, so the patient can settle online through a payment gateway the practice has set up, or without one. If the e-mail fails, the invoice says it was not sent rather than leaving you to assume it arrived.
A note for Nigerian and Kenyan practices: create these invoices from the invoice form under Accounting, which follows your country's tax codes. The New invoice form under Billing & Finance currently offers only South African VAT rates and shows rand.
Overdue reminders that run every day
Credit control is switched on for new workspaces. Once a day it looks for overdue invoices and e-mails a reminder to the patient, with the invoice PDF attached. By default the reminders go at 7, 14 and 30 days overdue. It never charges anyone, and it records whether each e-mail went out.
One detail matters for how you word your first e-mail: reminder e-mails carry no pay link. The pay link travels with the invoice itself. A pay link lasts 14 days by default, and once it has run out you can create another for the issued invoice and e-mail it again. If most of your patients pay online, make sure the original invoice goes out with its link, and send a new link when a patient asks how to pay.
A statement every month for every open account
Alongside the reminders, credit control e-mails a monthly statement of account to every patient with a balance. The statement is a PDF made by the server, so the patient sees their whole account in one document rather than a pile of separate invoices.
You can also produce a statement on demand, for a patient who calls to ask what they owe, and e-mail it from the same screen. The screen tells you whether that statement was sent.
Statements are especially useful for patients who pay in pieces. When a patient pays part of an invoice, the payment is recorded against it and the invoice shows as part-paid. If a patient pays more than the invoice, the extra is held on their account. The patient's account reflects all of this, so nobody has to work it out on the phone.
Seeing what went out and what is still owed
A routine you cannot see is a routine you stop trusting. Two things make this one visible.
First, every reminder and statement records whether it was sent. If a patient says they never heard from you, you can check rather than guess.
Second, the amounts owed are aged into five groups: 0-30, 31-60, 61-90, 91-120 and over 120 days, with overdue totals. That ageing is where reception's limited time should go. A balance in the first group usually needs nothing more than the automatic reminders. A balance that has drifted past 90 days needs a person to pick up the phone.
Here is a simple division of the work:
| Who | What they do | How often |
|---|---|---|
| Reception | Issue the invoice with a pay link as soon as the patient's portion is known | Daily |
| Credit control | Send overdue reminders and the monthly statement | Automatically |
| Practice manager | Read the ageing, call the oldest balances, check for failed e-mails | Weekly |
| Practice owner | Decide what to do about balances nobody can collect | Monthly |
When the reminders go quiet
Credit control depends on the workspace's e-mail settings working. If they are not set up, or stop working, reminders and statements cannot go out, and the sent records will show it. Check them when you first switch on and again after any change to your e-mail.
The other cause of silence is missing e-mail addresses. A patient with no address on file gets no reminder and no statement, however overdue the account. Capture an e-mail address at registration, confirm it whenever a patient updates their details, and keep a short list of patients who need a phone call or a printed statement instead.
Finally, decide in advance when a balance stops being reception's job. The daily run sends reminders and statements; deciding when an account needs a personal call is up to you, so agree with the practice owner at what age that happens and who makes the call. ICAEW's helpsheet on chasing debtors is a practical guide to that next stage: check your own processes, chase informally first, then choose the next step, with examples drawn from the UK.
Where to begin
Pull up the ageing for your practice this week and look at the oldest group first. Check that each of those patients has an issued invoice and a working e-mail address, then let the daily run take over the rest. For payments taken at the desk rather than on account, see giving patients a proper receipt at reception, and for Kenyan practices, taking M-Pesa at reception.
General guidance only, not advice on your own circumstances. Tax and payroll rules change: check the current position with the authority or your adviser.
