7 Ways Dental Practices Can Improve Accounts Recovery

On July 28, 2026   /   Client Education, Collections, Healthcare Debt  

7 Ways Dental Practices Can Improve Accounts Recovery

Dentist, mirror and woman with smile in consultation for teeth whitening, service and dental care. Healthcare, dentistry and female patient with orthodontist for oral hygiene, wellness and cleaning.

Providing exceptional patient care is your top priority, but maintaining a healthy cash flow is what allows your practice to continue delivering that care. As patient financial responsibility continues to grow, having a proactive collections strategy is more important than ever.

Many dental practices struggle with collections due to concerns about impacting patient relationships, navigating insurance, and other pitfalls. The good news? Many collection challenges can be prevented with the right processes in place long before an account reaches collections. Here are seven best practices that can help your dental practice improve patient payments, reduce aging accounts receivable, and preserve positive patient relationships.

1. Set Clear Financial Expectations Up Front 

Patients are far more likely to pay when they understand their financial responsibility before treatment begins.

Make sure your team:

  • Verifies insurance benefits before appointments
  • Provides clear estimates whenever possible
  • Reviews payment expectations before treatment
  • Obtains signed financial policies from new patients 

Transparent communication helps eliminate surprises and reduces billing disputes later.

2. Collect Payment at the Time of Service 

The easiest payment to collect is the one made before the patient leaves the office. 

Whenever appropriate, collect:

  • Copayments
  • Deductibles
  • Estimated patient portions
  • Outstanding balances from previous visits

Waiting until after treatment often leads to delayed payments and increased administrative work. 

3. Offer Convenient Payment Options 

Today’s patients expect flexibility. Making payments simple can significantly improve collection rates. 

Consider offering:

  • Online payment portals
  • Text-to-pay options
  • Automatic payment plans
  • Credit and debit card payments
  • Financing options for larger treatment plans

The easier it is to pay, the more likely patients are to do so promptly. 

4. Communicate Early and Consistently

A structured billing process encourages timely payment while maintaining a positive patient experience.

Develop a consistent communication schedule that includes:

  • Prompt billing after insurance processing
  • Friendly payment reminders
  • Multiple contact methods (mail, email, text, and phone)
  • Clear due dates and payment instructions

Many overdue accounts result from missed communications—not an unwillingness to pay.

5. Monitor Your Accounts Receivable Regularly

Reviewing your aging reports each month helps identify payment issues before they become larger problems.

Pay close attention to:

  • Accounts over 30, 60, and 90 days past due
  • High-dollar outstanding balances
  • Payment plan performance
  • Insurance delays versus patient balances

Regular monitoring allows your team to address issues early and improve overall cash flow.

6. Establish a Defined Collections Policy

Every dental practice should have a written policy outlining when internal collection efforts end and outside assistance begins.

Your policy should clearly define:

  • How many billing statements will be sent
  • When phone outreach begins
  • Payment plan guidelines
  • When accounts are referred to a third-party collection agency

Having consistent procedures creates fairness for patients while helping your staff manage accounts efficiently.

7. Partner with a Professional Collection Agency When Appropriate

Despite a practice’s best efforts, some accounts require additional follow-up. In addition, the administrative team may not have the manpower or know-how to consistently pursue collections.

Working with a professional healthcare collection agency allows your staff to stay focused on patient care while experienced collection specialists pursue unpaid balances using compliant, patient-focused communication.

Referring accounts at the appropriate time can help improve recovery rates, reduce internal administrative burden, and support a healthier revenue cycle.

A Strong Collections Strategy Starts Before Collections

Successful patient collections begin long before an account becomes seriously past due. By combining clear communication, convenient payment options, consistent follow-up, and defined internal processes, dental practices can reduce outstanding balances while maintaining positive patient relationships.

When accounts do require outside assistance, partnering with an experienced healthcare collections agency can help maximize recovery while protecting your practice’s reputation.

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What EMS Providers and Patients Should Know About Ambulance Billing

On June 23, 2026   /   Ambulance, Client Education, Collections, EMS, Healthcare Debt  

What EMS Providers and Patients Should Know About Ambulance Billing

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Emergency ambulance transportation is one of the most important services in healthcare—but it is also one of the most misunderstood when it comes to billing and insurance coverage. Recent reporting has highlighted the confusion many patients experience after receiving large ambulance bills, particularly when emergency transports are processed as out-of-network services.

For EMS and ambulance providers, these situations create challenges on both sides of the revenue cycle. Patients are often surprised by balances they did not expect, while providers face increasing operational costs, inconsistent insurance reimbursement, and rising accounts receivable.

Understanding the No Surprises Act

One major source of confusion surrounding ambulance billing is the assumption that all emergency transportation services are protected under the federal No Surprises Act. While the law does provide important protections for many emergency medical services, its coverage for ambulance transportation is limited.

The No Surprises Act, which took effect in 2022, was designed to protect patients from unexpected out-of-network medical bills during emergencies and certain non-emergency situations. However, the law generally applies only to air ambulance services—not most ground ambulance transports.

This means many patients who are transported by ground ambulance may still receive:

  • Out-of-network bills
  • Balance bills for unpaid portions of claims
  • Higher out-of-pocket expenses depending on their insurance coverage

Because patients cannot choose which ambulance provider responds during an emergency, these bills can come as a surprise.

Instead of “Great job,” try “Thank you for helping reduce outstanding balances this month by proactively contacting families before due dates.”

Why Ambulance Bills Can Be So High

Unlike many healthcare services, ambulance transportation operates within a highly fragmented system. Emergency transports may be provided by municipal departments, hospitals, nonprofit organizations, or private ambulance companies. Patients typically have no ability to choose which provider responds during a 911 emergency.

Several factors contribute to high ambulance balances:

  • Out-of-network reimbursement issues
  • Low reimbursement rates from Medicare and Medicaid
  • Costs associated with staffing, equipment, fuel, and compliance
  • Advanced life support (ALS) versus basic life support (BLS) services
  • Mileage and specialized care charges
  • Limited federal protections for ground ambulance billing

Industry reports and consumer research show that ambulance transports can cost hundreds to several thousand dollars depending on the level of care and insurance coverage involved.

The Ongoing Challenge of Insurance Reimbursement

Many ambulance providers report that insurance reimbursement often does not fully cover the cost of service. Many emergency ambulance transports involve out-of-network providers, which can leave patients responsible for balance bills.

At the same time, EMS organizations must maintain 24/7 readiness regardless of reimbursement outcomes. Personnel costs, vehicle maintenance, medical equipment, dispatch operations, and training all contribute to the financial pressures facing ambulance services.

This creates a difficult balance:

  • Providers need reimbursement to sustain operations
  • Patients often struggle to understand or afford large balances
  • Insurance carriers may reimburse below billed charges
  • Federal billing protections do not fully apply to ground ambulance services

Why Clear Communication Matters

One of the biggest opportunities for EMS providers is proactive patient communication. Confusion surrounding ambulance billing often leads to delayed payments, disputes, and increased collection timelines.

Educational outreach can help patients better understand:

  • How emergency transport billing works
  • What protections the No Surprises Act does and does not provide
  • Why insurance may process claims as out-of-network
  • What portions may apply to deductibles or copays
  • Available hardship or payment assistance programs
  • Steps they can take to request claim reviews or reprocessing

Providing this information early can improve patient engagement and reduce frustration throughout the recovery process.

The Importance of a Structured Recovery Process

Even with strong billing procedures, many ambulance providers still experience aging receivables that require additional follow-up. Accounts may remain unresolved due to:

  • Insurance disputes
  • Patient confusion about coverage
  • Incomplete documentation
  • Financial hardship
  • Lack of communication after initial billing

A structured collections strategy can help EMS organizations recover more outstanding balances while maintaining professionalism and compliance. Early intervention, accurate account documentation, and consistent communication are key components of successful recovery efforts.

Helping Patients Navigate Outstanding Balances

Patients are often unaware that they may have options when facing a large ambulance balance. Depending on the situation, they may be able to:

  • Request an itemized bill
  • Ask their insurance carrier to reprocess the claim
  • Review deductible and out-of-pocket obligations
  • Apply for hardship programs or payment arrangements
  • Verify whether any state-level balance billing protections apply
  • Resolve balances before accounts continue aging

For EMS providers, helping patients understand these options can improve resolution rates and reduce long-term delinquency.

Supporting Financial Stability for EMS Organizations

Ambulance and EMS providers operate in a challenging reimbursement environment while continuing to deliver critical emergency care to their communities. Maintaining financial stability requires a strong revenue cycle strategy that includes:

  • Accurate billing workflows
  • Timely insurance follow-up
  • Clear patient communication
  • Proper documentation
  • Effective recovery processes for aging accounts

As discussions around ambulance billing reform and expanded surprise billing protections continue nationwide, EMS providers must stay informed about evolving regulations while maintaining compliant and patient-focused recovery practices. Collections can serve as an extension of the patient communication process while helping providers recover revenue that supports ongoing emergency services.

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Motivating Your Team to Improve Accounts Recovery Outcomes

On April 17, 2026   /   Client Education, Collections  

Motivating Your Team to Improve Debt Recovery Outcomes

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Financial performance isn’t just about systems and processes—it’s about people. From front-desk staff and billing teams to administrators and finance departments, your ability to recover revenue depends heavily on how engaged your team is in the process.

Recent insights highlight a critical truth: the most effective motivation connects employees’ emotions to their responsibilities—not just their tasks.

For organizations managing overdue accounts, this connection can make the difference between delayed revenue and consistent cash flow.

Collections staff are often responsible for sensitive financial conversations. These include:

  • Explaining balances to consumers
  • Following up on unpaid accounts
  • Coordinating with third-party collection agencies
  • Ensuring accurate and timely billing

When employees see these responsibilities as routine or uncomfortable tasks, performance suffers. But when they understand how their role directly impacts the organization’s mission and financial health, engagement—and results—improve.

Employees who feel emotionally connected to their work are more likely to:

  • Communicate more effectively with consumers
  • Follow through on outstanding balances
  • Reduce delays that lead to collections placement

This is the foundation of stronger internal collections—and ultimately, better outcomes when accounts are escalated externally.

The Most Effective Motivators (and How to Apply Them)

1. Recognition Drives Accountability

One of the most powerful motivators is simple: approval and recognition.

For your team, this means:

  • Acknowledging staff who successfully resolve accounts early
  • Highlighting effective consumer communication
  • Publicly recognizing improvements in A/R performance

The key is specificity. Generic praise doesn’t move the needle—but tying recognition to meaningful outcomes does.

Instead of “Great job,” try “Thank you for helping reduce outstanding balances this month by proactively contacting families before due dates.”

2. Connect Daily Tasks to Organizational Impact

Employees are more engaged when they understand how their work contributes to a larger mission.

In your organization:

  • Show how early payment conversations reduce the need for collections
  • Explain how improved cash flow supports the organization
  • Reinforce that their role helps minimize financial stress for consumers

When staff see the why, they are more likely to take ownership of the how.

3. Use Incentives Carefully

Financial incentives can be effective—but only when used thoughtfully.

While bonuses or rewards can reinforce appreciation, they should not be the primary motivator, as they can quickly become expected rather than earned.

Instead:

  • Use incentives to reinforce exceptional performance
  • Pair them with clear communication about why they were earned
  • Avoid creating entitlement or internal competition that harms collaboration

4. Avoid Fear-Based Motivation

In high-pressure environments like healthcare and education, it can be tempting to push urgency through pressure.

However, fear-based motivation often leads to:

  • Poor communication with consumers
  • Increased errors in billing or documentation
  • Lower morale and higher turnover

A better approach is to emphasize shared goals. For example, you might say “If we improve our follow-up process, we can reduce accounts going to collections and improve the consumer experience.”

5. Build a Culture of Ownership—Not Guilt

Motivation should encourage responsibility, not resentment.

Rather than framing missed collections as failures:

  • Focus on solutions and process improvements
  • Encourage accountability without blame
  • Provide tools and training to support success

This creates a more sustainable and professional environment—especially important in industries built on trust

Turning Insight into Action

Improving collections isn’t just about policies—it’s about people.

By focusing on:

  • Meaningful recognition
  • Clear connections between roles and outcomes
  • Thoughtful use of incentives
  • A culture of accountability

…you can create a team that is not only more engaged, but more effective in protecting your organization’s financial health. This results in a stronger, more predictable revenue cycle.

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How Educational Institutions Can Increase Accounts Recovery

On March 25, 2026   /   Client Education, Collections, Education Debt, News  

How Educational Institutions Can Increase Debt Recovery

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The Department of Education recently issued new guidance to colleges and universities, asking them to increase their efforts to reduce student loan delinquencies and defaults. Over 1,800 institutions currently have nonpayment rates of 25% or higher—your institution may be one of them.

For colleges, universities, and private educational institutions, unpaid balances are more than an administrative burden—they directly impact cash flow, staffing, and long-term planning. So how do you increase your recovery rates? By building strong internal processes for accounts, relying on collections as a last resort.

Below are proven strategies your institution can implement now to improve payment outcomes.

Set Clear Payment Expectations from Day One

The strongest collections strategy starts at enrollment.

Clearly outlining tuition, fees, due dates, and consequences of non-payment ensures students and families understand their financial responsibility upfront. When expectations are documented and agreed upon early, disputes—and delays—are far less likely.

Best practices:

  • Include full cost breakdowns (tuition, housing, fees, etc.)
  • Require signed financial agreements
  • Clearly define due dates and late penalties
  • Explain what happens if balances remain unpaid (including collections)

Clarity reduces confusion—and confusion is one of the leading causes of non-payment

Send Accurate, Timely Invoices

Delays in billing lead directly to delays in payment.

Invoices should be sent as soon as balances are finalized and must include:

  • Clear due dates
  • Accurate charges
  • Easy-to-understand descriptions
  • Payment instructions

Even small errors or delays can significantly slow down your revenue cycle and create unnecessary follow-up work.

Make Paying Easy and Convenient

If it’s difficult to pay, people delay.

Providing multiple payment options removes friction and increases on-time payments. Good options to offer include:

  • Online portals
  • ACH
  • Credit/debit cards
  • Mobile payments

Institutions that streamline the payment experience often see faster payments, fewer delinquencies, and reduced administrative workload.
Convenience is no longer optional—it’s expected.

Offer Structured Payment Plans

Large tuition balances can be overwhelming. Payment plans make them manageable.

By allowing families to pay over time, institutions can:

  • Increase the likelihood of repayment
  • Prevent accounts from becoming delinquent
  • Build goodwill with students and families

Flexible options often turn potential bad debt into consistent, predictable cash flow.

Establish a Defined Late Payment Policy

Consistency is critical.

A clear, documented process for handling past-due accounts ensures that every account is treated the same—and addressed promptly.

Your policy should include:

  • When follow-ups begin
  • Communication cadence (email, phone, letters)
  • Late fees or penalties
  • Timeline for escalation or collections placement

Institutions with structured policies resolve delinquencies faster and with less internal effort.

Use Data to Identify At-Risk Accounts Early

Not all accounts behave the same.

Tracking payment behavior allows you to identify trends and intervene earlier. For example:

  • Repeat late payers may benefit from proactive outreach
  • Accounts trending delinquent can be escalated sooner
  • High-risk accounts can be flagged for faster action

Monitoring metrics like Days Outstanding and delinquency rates helps institutions stay ahead of problems instead of reacting to them.

Automate Payment Reminders

Consistency drives results—and automation makes consistency possible.

Automated reminders ensure that students and families receive timely, professional nudges before and after due dates. This reduces the need for manual follow-up and significantly improves payment timing.

In fact, combining communication channels like email and SMS can dramatically increase the likelihood of prompt payment.

Provide Financial Support Options

Sometimes non-payment isn’t avoidance—it’s inability.

Offering financial aid guidance, scholarships, or adjusted payment options can help students stay current and prevent accounts from escalating.

This approach not only improves recovery but also strengthens your institution’s reputation and relationships.

Know When to Escalate to Collections

Even with strong internal processes, some accounts will require outside intervention. The key is timing.

Accounts placed too late are significantly harder to recover. By establishing a clear escalation timeline and partnering with a trusted agency early, you can:

  • Increase recovery rates
  • Reduce internal workload
  • Maintain compliance and professionalism

A good collections partner works as an extension of your team—helping you recover balances while preserving the relationships you’ve built.

Final Thoughts

Improving debt recovery isn’t just about what happens after an account goes unpaid—it’s about everything that happens before.

Educational institutions that prioritize:

  • Clear communication
  • Process consistency
  • Early intervention
  • Payment flexibility

…consistently see stronger financial outcomes and fewer accounts requiring collections.

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How NOT to Need an Accounts Receivables Agency

On February 17, 2026   /   Client Education, Collections, News  

How NOT to Need a Collection Agency

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Many businesses want to avoid sending customers to collections due to added cost, work, compliance concerns. They’re also concerned that taking this action could harm their reputation and negatively impact their relationship with their customers. At the same time, overdue accounts strain cash flow. The truth is that many accounts that reach collections may have been resolved earlier through clearer communication, consistent processes, and proactive engagement.

Here are practical best practices to reduce escalation and keep more accounts from ever reaching collections.

Set Your Employees and Customers Up for Success

Prevention starts before the first invoice is sent.

Create a written policy outlining:

  • How customers should be treated
  • Required customer information
  • Payment terms
  • Collection policies
  • When and how billing occurs

Have both employees and customers review and acknowledge it.

Use a thorough intake form that collects accurate phone numbers, addresses, and emails—and verify the information. Incomplete or incorrect contact details are a major cause of payment delays.

Keep your front desk and billing teams up to date on processes and billing cycles.

Upfront payment terms should be clear, transparent, and easy for the consumer to understand. At a minimum, contracts or financial policies should include:

  • Who is financially responsible for the balance (patient/consumer vs. insurance)
  • When payment is due and acceptable payment methods
  • What happens if payment is not received, including late fees (if applicable)
  • Your billing and statement process, including how often statements are sent
  • Insurance-related language, clarifying that the consumer is responsible for balances not covered by insurance
  • Payment plan options and how to request them
  • Authorization to communicate about the account (mail, phone, email, text, where permitted)
  • Disclosure that unpaid balances may be sent to a third-party collection agency

Clear upfront language helps set expectations, reduces confusion and disputes, and makes any later collection efforts more effective and compliant.

Make Billing Timely, Clear, and Consumer-Friendly

Send the first statement as soon as the balance is finalized. Delays reduce urgency and increase confusion.

Every statement should clearly include:

  • Amount due
  • Due date
  • Explanation of charges
  • Payment options
  • Contact information
  • Dispute instructions and how to ask questions

Avoid jargon. Clarity reduces disputes and increases payment likelihood.

Use Consistent, Multi-Channel Follow-Ups

Before escalation, most accounts should receive 3–4 notices, spaced consistently, using multiple communication methods. While many businesses follow a 30/60/90-day cycle, shorter intervals (such as every 15 days) help keep balances top of mind.

Use multiple communication methods:

  • Mailed statements
  • Email reminders
  • Text notifications (when possible)
  • Phone calls

Consistency signals that the balance matters. Ensure your billing team is knowledgeable and accessible—strong customer service encourages resolution.

Offer Flexible Payment Plans

Payment plans are one of the most effective tools for preventing collections.

Not every customer can pay in full immediately, but many can commit to structured installments. Make requesting a plan simple and document agreements clearly.

Resolve Disputes and Errors Quickly

Unresolved disputes and billing errors frequently drive unnecessary collections placements.

  • Address disputes promptly with clear explanations of services, insurance payments, adjustments, or denials.
  • Maintain strong internal recordkeeping and conduct regular audits to reduce errors.
  • Clearly explain what insurance covered and what remains the customer’s responsibility.

Transparency prevents frustration and premature escalation.

Use a Professional Final Notice

A final notice creates urgency while offering one last opportunity to resolve the balance internally.

It should clearly state:

  • Balance due
  • Payment deadline
  • Payment options
  • That the account may be sent to collections

Use the word “collections” factually and professionally. Transparency helps motivate action and avoids complaints later that the consumer “was never told.”

The tone should always remain professional, courteous, and solution-focused—not aggressive or threatening.

Most businesses allow 10–30 days after the final notice before sending an account to collections.

Know When to Escalate

Even with best practices, some accounts will not resolve internally.

You’re generally allowed to send an account to collections once the balance is past due, the payment responsibility is clear, and you’ve made reasonable attempts to collect internally. While there’s no single rule that applies to every situation, best practice typically includes:

  • The account has aged past your internal billing cycle (often 60–120 days, depending on your policy)
  • All insurance, adjustments, and disputes have been resolved
  • Clear, compliant billing statements and follow-up notices have been sent
  • The consumer has been given sufficient time and opportunity to respond or pay

It’s also important to follow state and federal regulations, including FDCPA requirements once the account is placed with a third-party agency, and any industry-specific rules (such as healthcare billing standards).

Having a clearly documented, consistent policy helps ensure accounts are placed appropriately, reduces consumer complaints, and improves recovery outcomes.

The Bottom Line

Most accounts reach collections due to confusion, delays, or inconsistent follow-up—not unwillingness to pay.

You can reduce placements and improve customer experience by focusing on:

  • Clear upfront agreements
  • Prompt, understandable billing
  • Consistent follow-ups
  • Flexible payment options
  • Accurate records
  • Transparent final notices

Prevention is about communication, consistency, and clarity from day one.

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Privacy and AI in Modern Accounts Receivables

On November 19, 2025   /   Client Education, News, Technology  

Privacy and AI in Modern Debt Collection

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The use of AI has rapidly increased over the past few years and doesn’t appear to be slowing down anytime soon. Many believe that AI tools will be a permanent fixture in our lives and businesses. At the present moment, though, AI is still a budding industry and many are concerned about its use in financial services, including debt collection. 

Common Company and Consumer Concerns

As a company conducting in-house collections or utilizing a third-party debt collection agency, you’re likely excited about the possibilities that AI can bring to the space—but also worried about the potential downsides.

Chief among these concerns is privacy and compliance, as AI systems often handle sensitive consumer data. If AI uses that data inappropriately, becomes a target of malicious actors, or malfunctions in some way, your business—and consumers—could be at risk. A data breach, for instance, can be devastating, costing a company money and manpower to fix and forever losing consumers’ trust.

Even without a large-scale violation, AI can make compliance more difficult by obscuring decision-making processes and lowering transparency. Many employees use AI tools without the knowledge of their superiors, further complicating compliance. A report by McKinsey & Company found that 78% of employees use AI tools not provided by their employer. This further opens a company up to risk and compliance violations.

While consumers are also worried about AI mishandling their personal information, they’re concerned about AI trying to steal it as well. A study from Queen Mary University of London discovered that AI voices and voice cloning tools can replicate human voices so closely that they can trick consumers into thinking they’re real people. Study participants believed that cloned voices were real 58% of the time and believed that generic AI voices were real 41% of the time. If misused by scammers, this tool could cause serious damage.

Despite how common AI is becoming, many consumers still don’t trust it. Forrester’s 2025 “Consumer Insights: Trust In AI” reports found that only 24% of Americans feel knowledgeable about AI, and only 15% of American adults trust companies that use AI with consumers.

Benefits of AI

Despite the risks, AI is still an incredible technology with a lot of benefits if used correctly and with care.

AI can save debt collection companies money in various ways. Repetitive tasks like processing payments and sending payment reminders can be automated, saving time and reducing errors. AI can handle routine communication at scale, reducing the need for large agent teams and lowering operational costs. AI pilot programs in US agencies reported a 35% reduction in missed payment reminders, speeding up debt recovery cycles.

On a related note, AI has been shown to improve debt recovery rates across the board. Predictive analysis allows agencies to find trends in consumer behavior, find out the likelihood of repayment, and create customized collection strategies to improve the chances of debt recovery. These analytics can also help agencies develop more long-term strategy around everything from high-risk accounts to the day-to-day collection process.

Even though many customers are distrustful of AI, the technology can greatly improve customer service. AI chatbots and virtual assistants offer personalized communication to consumers with questions or issues. These services are incredibly responsive; available 24/7 and answering queries nearly-instantly. AI can also be used to tailor outreach strategies, particularly for high-risk accounts. This not only increases the likelihood that these accounts will be paid, but also increases customer satisfaction.

ACA Actions

American Collectors Association (ACA) International consistently stays up to date with the latest information about AI in the debt collection space. As AI adoption has increased across financial services, their advocacy on AI aims to support both protection of consumers and operational efficiency of debt collection agencies. Their recent advocacy has been focused on the following points:

  • Supporting risk-based AI regulation to prioritize mitigating potential harm
  • Differentiating interactive programs that utilize pre-programmed datasets from more advanced AI systems under the law
  • Increasing flexibility for consumers, allowing them to access information and services beyond business hours
  • Preventing discrimination from AI tools
  • Urging policymakers to consider and address the risk of AI being used for fraud
  • Utilizing AI to monitor and streamline legal and regulatory compliance

ACA continues to provide comments on federal request for information and to work with policymakers to ensure that consumers are protected and collection agencies have their needs met.

FFR does not currently use AI, and we will be sure to let you know if and how we decide to implement it in the future.

Sources:

https://www.acainternational.org/news/new-bill-seeks-to-close-the-ai-gap-for-small-businesses/

https://www.nibusinessinfo.co.uk/content/risks-and-limitations-artificial-intelligence-business

https://www.acainternational.org/news/is-there-ai-shame-in-your-workplace/

https://www.acainternational.org/news/ai-voice-technology-reaches-human-level-realism/

https://www.forrester.com/blogs/consumers-are-using-ai-but-they-still-dont-trust-it/

https://www.experian.com/blogs/insights/ai-in-debt-collection-benefits-and-uses/

https://rtslabs.com/ai-debt-collection/

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Federal vs State Rules on Medical Debt Credit Reporting

On November 13, 2025   /   Ambulance, Client Education, EMS, Healthcare Debt, News  

Federal vs State Rules on Medical Debt Credit Reporting

Conceptual image of a stethoscope on a credit card, could illustrate ideas around health of ones credit score or economy

On October 27, the Consumer Financial Protection Bureau (CFPB) formally confirmed that the Fair Credit Reporting Act (FCRA) broadly preempts state laws on credit reporting. You may be wondering what this means for your medical practice’s accounts in collections and how this will change the landscape going forward. To learn more about that, we first need to look at how this new interpretive rule came about in the first place.

How We Got Here

After being established in 1970, the FCRA has gone through several amendments to modernize it as the consumer reporting landscape changed. The FCRA has always preempted state law, that is, its provisions have always overruled state guidance. Over time, however, the exact scope of this preemption has changed. The FCRA has so far only preempted laws that were directly inconsistent with its provisions, meaning that states were free to issue their own laws so long as they did not contradict the FCRA’s regulations.

One example of this is how various states handle medical debt and credit reporting. The FCRA does not have any specific provisions regarding how medical debt should be addressed, so many states have developed their own laws in the interest of protecting consumers. Fifteen states have passed laws limiting or completely banning credit reporting on medical debt, while the rest treat medical debt mostly like any other type of debt.

Back in July 2022, the CFPB issued an interpretive rule stating that the FCRA has a limited preemptive scope, allowing states to continue to pass and enforce their own credit reporting laws where they didn’t explicitly conflict with FCRA provisions. However, this rule was withdrawn in May 2025.

The October 27 issuance is what the CFPB is replacing the 2022 interpretation with, stating that the old rule was unnecessary, confusing, and burdensome. This new issuance attempts to restore standardization across the country by making states comply with the letter of the FCRA only, no longer allowing for interpretation by individual states.

What This Means For You

This rule has the potential to significantly impact your medical practice. If you’re located in a state where medical debt credit reporting has been banned or restricted, you may be eager to start credit reporting, or have your debt collection agency do the same.

However, the rule is still quite new, and for now, state regulations are still in play. Interpretive rules such as this one are considered guidance, and it’s the courts that will determine exactly how this provision will impact the law. Over the coming months, you can expect to see many groups challenging (consumers, advocacy groups) or defending (medical practices, banks) the new rule in court. Already, the American Collectors Association (ACA) has filed suit, challenging Colorado’s House Bill 23-1126; the country’s first state law prohibiting the reporting of medical debt information on credit reports.

In the meantime, debt collection agencies—including us at FFR—will operate as usual, following state laws where they apply while simultaneously keeping an eye on unfolding legal cases and upcoming legislation. The landscape has been in flux for some time, but FFR will keep up with any and all regulatory changes, keep you informed as needed, and continue to collect compliantly and compassionately.

Sources:

https://www.accountsrecovery.net/2025/10/28/cfpb-reasserts-federal-preemption-of-state-credit-reporting-laws/

https://www.consumerfinancialserviceslawmonitor.com/2025/10/cfpb-revokes-2022-interpretive-rule-on-fcra-preemption-scope/

https://www.newsweek.com/millions-could-see-medical-debt-added-to-credit-reports-10952250

https://www.huschblackwell.com/newsandinsights/cfpb-publishes-new-interpretive-rule-supporting-broad-fcra-preemption

https://www.federalregister.gov/documents/2025/10/28/2025-19671/fair-credit-reporting-act-preemption-of-state-laws

https://www.acainternational.org/member-alert/aca-is-taking-legal-action-against-colorado-medical-debt-reporting-ban/

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Medical Debt and Credit Reporting: What Healthcare Providers and EMS/Ambulance Leaders Need to Know in 2025

On October 27, 2025   /   Client Education, Education Debt, News  

Medical Debt and Credit Reporting: What Healthcare Providers and EMS/Ambulance Leaders Need to Know in 2025

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Numerous changes and proposed rules regarding medical debt and credit reporting have been created, codified, or blocked over the past few years. You may have heard that medical debts in small amounts are no longer reported on credit reports, or that all medical debt has been wiped from reports. It can be difficult to figure out what the rules really are, and those in healthcare and medicine have been asking us: What actually changed? How does this work going forward?

The short answer: it depends. Rules differ across state lines, and federal regulations have been in flux this year. It’s vital for healthcare providers, ambulance services, EMS providers, and their billing partners to understand this ever-changing landscape.

Timeline of changes:

  • In January 2022, the No Surprises Act was enacted to address unexpected medical bills that occur from emergencies. The goal of this law is to protect patients by making costs clearer, prohibiting balance billing, and other changes.
  • In March 2022, the three major credit bureaus—Equifax, Experian, and TransUnion —announced that they would no longer be including paid medical debts, medical debts less than a year old, and medical debt under $500 on consumer credit reports. It’s estimated that this affected roughly half of consumers with medical debt on their credit reports.
  • In January of this year, the Consumer Financial Protection Bureau (CFPB) finalized a rule that would have removed most medical debt from credit reports and prohibited lenders from making credit decisions based on medical debt. This rule was expected to go into effect in March, however, this was prevented by a lawsuit challenging it.
  • In July, the rule was blocked by a federal judge in Texas, and the CFPB agreed to vacate the rule. This means that the rule will no longer go into effect.

Although medical debt as a whole has not been removed from credit reports, some states have more restrictions than others when it comes to consumer protections. As of June 2025, 11 states have enacted laws restricting, or even banning, the reporting of medical debt to consumer reporting agencies.

What does this mean for patients?

As stated, it’s complicated. Any ambulance or other unpaid medical bills may show up on their credit report, but they may not. Patients are less likely to see these bills on their credit report if their bills are small, if they are paid off quickly, or if the patient received care in a state with stricter consumer protections. Larger medical debts in collections that go unpaid for more than a year can still affect a patient’s credit score, but credit scoring models like FICO 9, FICO 10, and VantageScore 4.0 weigh them less heavily than other types of debt.

What does this mean for healthcare institutions and medical companies?

Companies that rely on debt collection agencies need to be aware of how the agency they work with operates, and what they can do as a company to help the collections process go smoothly. Here some things to keep in mind:

  • Accuracy is key. The record of the bill itself is important, but so are patient identifiers like date of birth and insurance history. Missing information can result in errors, compliance issues, and potentially cause the debt to be unreportable.
  • Know your collector’s policies. Some agencies continue reporting debts above $500, while others no longer report medical collections at all. Ask direct questions about thresholds, timing, and dispute procedures.
  • Stay informed of your state’s policies. Given the difference in consumer protections across different states, it’s important to stay abreast of your state’s rules and regulations. If you operate in multiple states, don’t assume that they have the same standards.
  • Communicate well with patients. The easiest way to get payment on a balance is to do it before it reaches collections in the first place. To do this, give your patients transparency on their billing statements, multiple payment plan options to choose from, and access to financial assistance programs to help them settle their balance quickly and easily.

The bottom line

Medical debt reporting has gone through some drastic changes over the past few years, but it hasn’t gone away completely. Though many debts were removed in 2022-2023, the rule that would’ve eliminated them all has been blocked for the time being. Whether or not a bill affects a patient’s credit report depends on how large the debt is, what the collector’s policies are, and where the patient lives.

The best way to ensure that your company is settling patient balances within regulations is to work with a collection agency that is compassionate with patients and compliant with state laws. Protect your company and community and set both up for success by prioritizing clear communication, compliance, and accuracy in collections.

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What the Affordable Care Act’s 80/20 Rule Means for Your Health Insurance

On September 17, 2025   /   Ambulance, Client Education, Collections, Education Debt, EMS, Healthcare Debt, News  

What the Affordable Care Act’s 80/20 Rule Means for Your Health Insurance

8020

Health insurance can feel complicated, but one of the most consumer-friendly protections built into the Affordable Care Act (ACA) is something called the 80/20 Rule. This rule, also known as the Medical Loss Ratio (MLR) requirement, was designed to make sure you get the most value out of the money you spend on health insurance premiums.

What is the ACA’s 80/20 Rule?

Under the ACA, insurance companies must spend the majority of the premium dollars they collect on actual medical care and health-related services, not on profits or administrative expenses. Specifically:

  • For individual and small group plans, insurers must spend at least 80% of premium dollars on medical care and quality improvement.
  • For large group plans (usually offered by bigger employers), that requirement increases to 85%, leaving only 15% for overhead and profit.

This means that when you pay your health insurance premium each month, most of that money goes directly towards covering doctor visits, hospital stays, prescriptions, and programs that improve health outcomes.

The 80/20 Rule protects employees in several ways. First, it ensures that the money you contribute towards health insurance is being used primarily for your care, rather than administrative costs like advertising or executive salaries. This creates more value for employees and families, helping to keep coverage focused on health rather than profits.

Second, the Rule promotes transparency. Insurance companies are required to report how they spend premium dollars each year. If they don’t meet the 80/20 standard, they must issue rebates. Sometimes these rebates go directly to employees, but often they are sent to employers, who are then obligated to use the funds to benefit their workers, such as reducing premium contributions or enhancing coverage options.

For example, if your insurer collects $1,000 in premiums, at least $800 must be used to pay for medical care and health services. Only $200 can be used for overhead or profit. If the insurer only spends $750 on care, it hasn’t met the standard, and the difference must be refunded to policy holders.

For employees, this rule offers reassurance that your health insurance premiums are truly working for you. It also keeps insurance companies accountable, ensuring that health coverage remains more affordable and consumer friendly.

The Affordable Care Act’s 80/20 Rule may not be something you hear about every day, but it is a powerful protection. It guarantees that most of your premium dollars are invested directly into your health care, and if an insurance company falls short, you could receive a rebate.

For more information, please visit: Rate Review & the 80/20 Rule | HealthCare.gov

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When Is It Time to Take Legal Action on an Unpaid Account? A Practical Guide to Escalating Accounts Receivables

On August 6, 2025   /   Client Education, Education Debt, News  

When Is It Time to Take Legal Action on a Debt? A Practical Guide to Escalating Collections

Legal Picture

As every creditor knows, there comes a point in some collection efforts when traditional methods aren’t enough. But when is the right time to stop collection activity and consider legal action?

Pursuing a judgement is not a decision to be taken lightly, it requires a careful, strategic approach. Here is what you need to know before heading down the legal path.

What Does Legal Action Really Mean in Collections?

Legal action typically involves hiring a lawyer and filing a lawsuit to obtain a judgement, a court order that formally recognizes a debt. Once obtained, this judgement can be enforced through methods such as:

  • Wage garnishment
  • Bank levies
  • Property liens

However, not all debts are worth litigating, and not all debtors are collectible—even with a judgement in hand.

 

What You Can’t Collect Through Legal Action

One of the most important limitations to understand: retirement funds like IRA’s and 401(k)s are protected from garnishment. So, if a debtor’s only assets are retirement accounts, legal action may not result in recovery.

Also, judgements don’t last forever. They can expire, typically in 7-20 years depending on the state, although many can be renewed. This makes timing and follow-through essential.

Is This Judgement Worth Pursuing?

Before moving forward with litigation, consider the following factors:

  • Debtor’s Age: Is the debtor nearing retirement? Are they likely to have income in the future?
  • Current Employment: Are they working, or do they have a steady income?
  • Earning Potential: Even if unemployed, do they have career history, education or skills that suggest future earnings?
  • Asset Ownership: Do they own property or valuable assets that a lien could attach to?
  • State Laws: Garnishment limits and judgement renewal terms vary widely. Make sure you know what’s enforceable in your jurisdiction.
  • Insurance: Does the debtor have applicable insurance that could cover part or all of the balance owed?

Pre-Litigation Vetting is Key

This is where strong collaboration between your collection agency and legal counsel comes into play. Pre-litigation vetting ensures:

  • You don’t waste time and money on uncollectible debt
  • All relevant account and consumer information is reviewed
  • The strategy is in line with local laws

Empathy Still Matters

Legal action doesn’t mean throwing compassion out the window. In fact, empathy is one of the most valuable skills a collection attorney can have. Understanding a debtor’s circumstances can lead to more productive conversations – and often better settlement outcomes.

Sometimes, simply obtaining the judgment creates the pressure needed to incentivize a resolution. It becomes a bargaining tool rather than a battle.

What’s the Recovery Rate in Litigation?

On average, the recovery rate for accounts that go through litigation hovers around 25%. Although this is not a substantial amount, it may make sense for high-balance accounts or situations where the debtor is clearly collectible.

Factors That Impact Recovery Rates:

  • Type of Debt: Medical and education debt may differ in collectability from credit card or commercial debt
  • State Laws: Wage garnishment limits, exemption laws and duration vary by state
  • Debtor Profile: Employed debtors with attachable wages or assets are more collectible
  • Amount of the Debt: Higher balance accounts often justify legal action and are more likely to be pursued more aggressively.
  • Legal Strategy & Follow Up: Attorneys who actively enforce judgements (ex. Garnishments, liens) often recover more.
  • Insurance: In certain cases–especially involving accidents, property damage or services rendered—and insurance policy may be available to cover some or all of the debt. If insurance coverage applies, it can significantly improve the chance of recovery, especially if the debtor is otherwise uncollectable.

The Bottom Line

Litigation can be costly and slow. If you are considering legal action, partner with an experienced collections attorney who can:

  • Vet the debt thoroughly
  • Advise on state specific laws
  • Approach debtors with the right mix of firmness and empathy

Litigation should always be the last resort—but when done correctly it can be a powerful one.

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