What are the dynamics of patient accounts receivable? What are some of the factors affecting patients accounts receivable?.

             Facing the challenge of how to address the hospital's unpaid accounts receivable can be one of the most emotionally draining issues for a patient accounts receivable department. In addition to people simply not paying their payments, the department must face patients who cannot pay, who did not understand that their insurance would not cover a procedure, or patients who simply refuse to pay because they fault the hospital for inappropriate care. .

             Such a combination of patient"s financial, insurance, legal, and emotional complaints often drives some hospitals to explore the option of moving their accounts receivable from a primary collecting agency within the hospital to a secondary agency. But once a hospital has written an accounts receivable off to bad debt and sends it somewhere else, it can be very cumbersome transferring all that data from one agency to another. Also, when a hospital sells its bad debt to more experienced bill collecting agencies, the tactics of such agencies can make it difficult for health care providers to maintain a positive image in the community. "Our number one concern was that once we sold the accounts, we would lose all control," said the director of one accounts receivable department that was considering pursuing such an option. "We didn't want a bunch of bad public relations in the community,." (HFM, 2004).

             Most collection agencies deal with the vast majority of debtors who are defaulting on their credit cards. This often requires a different emotional dynamics with the borrower than health care debt, which is often taken on because of necessity, and little other reason, by comparatively conservative consumers. However, if a hospital chooses a debt buyer carefully, some agencies will allow hospital leaders remain in control throughout the process and to keep community relations as positive as possible as well.