What the statutes mean

When you attempt to collect money from a patient, you may not:

• Threaten to harm the patient or their property.
• Threaten criminal prosecution.
• Disclose any false information about the patient’s credit worthiness.
• Threaten to disclose any false information about the patient’s credit worthiness.
• Threaten to communicate with the patient’s employer unless you have obtained a final judgement on the patient. You may, however, verify the patient’s employment or the amount they earn.
• Disclose any information affecting the patient’s reputation to anyone other than the patient or their spouse unless you have the patient’s permission or you are required to do so by statute.
• Threaten to disclose any information affecting the patient’s reputation to anyone other than the patient or their spouse unless you have the patient’s permission or you are required to do so by statute.
• Disclose the existence of the debt without also disclosing the fact that the patient disputes the debt.
• Threaten to disclose the existence of the debt without also disclosing the fact that the patient disputes the debt.

• Communicate with the patient, or anyone related to the patient, in a way that threatens or harasses the patient. The statutes consider the following to be threats or harrassment:

– Very frequent phone calls or letters
– Phone calls or visits at unusual hours
– Abusive conduct

• Use obscene or threatening language in your phone calls or letters.
• Threaten to take an action unless you know with certainty that you have the right to take the action.
• Communicate with your patient in a way that gives an appearance that your communication comes from an attorney or the government or gives the appearance that it has been authorized or issued by an attorney or the government.

Practical advice

• Use common sense. Asking patients to make payments that are not reasonable will not help you achieve your objective of having the account paid in full.

• Every deal you make with a patient in an advisarial situation should be confirmed in writing.

• Do not wait to see if a patient will keep their commitment. Make a pleasant reminder call a day or two before a payment is due.

• Do not ever threaten a patient. If you are going to take an action, tell the patient in a professional manner what you are going to do and why you are going to do it - and make sure you do it.

• Your dispute is with the patient. You will almost surely violate the law if you try to involve the patient’s family,friends or employer in the dispute.

• There is nothing wrong with being an aggressive professional, but stepping over the line with abusive language or unprofessional conduct will not help you collect your money and may get you in trouble with the law.

“An ounce of prevention is worth a pound of cure”. When you get to the stage where you need to take action against a patient that has not paid his or her bill, you have the right to use your staff or collection agencies to aggressively collect the money that is due to you. However, when a patient is no longer voluntarily paying for their services and must be told to do so, you have changed the nature of your relationship with the patient.

Patients that receive constant letters and phone calls from your office, or that of a collection agency, demanding payment for services are not likely to remain patients very long. Nor are they likely to refer other patients to you. In fact, the patient may make up a story expressing dissatisfaction with the care they received as an excuse not to pay the bill. None of this is good for business because you suffer twice. The patient will probably not come back and you lose the new patients that this individual might have referred to you.

Prevention is the answer. The discussion of payment terms and the enforcement of those terms in a consistent manner are essential elements of a well run practice. It is essential that you have a well-trained and motivated staff person handle this responsibility. Ignoring the daily process of collecting co-pays, deductibles and payments on an account will lead to higher than average write-offs and, disgruntled patients, and reduced referrals. The Managing Receivables text available from the Wisconsin Chiropractic Association is an invaluable guide to help you develop the procedures you need to run this part of your practice.

Statute excerpts

103.68 Limits on hours of labor
103.70(1) Permits necessary for minors
103.74 Duties of employers of minors

427.103 Definitions of “claim”; “debt collection”; “debt collector”.

427.103(1) “Claim” means any obligation or alleged obligation arising from a consumer transaction, including a transaction that is primarily for an agricultural purpose.

427.103(2) “Debt collection” means any action, conduct or practice of soliciting claims for collection or in the collection of claims owed or due or alleged to be owed or due a merchant by a customer.

427.103(3) “Debt collector” means any person engaging, directly or indirectly, in debt collection.

427.104 Prohibited practices.

427.104(1) In attempting to collect an alleged debt arising from a consumer credit transaction or other consumer transaction where there is an agreement to defer payment, a debt collector may not:

427.104(1)(a) Use or threaten force or violence to cause physical harm to the customer or the customer’s dependents or property;

427.104(1)(b) Threaten criminal prosecution;

427.104(1)(c) Disclose or threaten to disclose information adversely affecting the customer’s reputation for credit worthiness with knowledge or reason to know that the information is false;

427.104(1)(d) Initiate or threaten to initiate communication with the customer’s employer prior to obtaining final judgment against the customer, except as permitted by statute including specifically s. 422.404, but this paragraph does not prohibit a debt collector from communicating with the customer’s employer solely to verify employment status or earnings or where an employer has an established debt counseling service or procedure;

427.104(1)(e) Disclose or threaten to disclose to a person other than the customer or the customer’s spouse information affecting the customer’s reputation, whether or not for credit worthiness, with knowledge or reason to know that the other person does not have a legitimate business need for the information, but this paragraph does not prohibit the disclosure to another person of information permitted to be disclosed to that person by statute;

427.104(1)(f) Disclose or threaten to disclose information concerning the existence of a debt known to be reasonably disputed by the customer without disclosing the fact that the customer disputes the debt;

427.104(1)(g) Communicate with the customer or a person related to the customer with such frequency or at such unusual hours or in such a manner as can reasonably be expected to threaten or harass the customer;

427.104(1)(h) Engage in other conduct which can reasonably be expected to threaten or harass the customer or a person related to the customer;

427.104(1)(i) Use obscene or threatening language in communicating with the customer or a person related to the customer;

427.104(1)(j) Claim, or attempt or threaten to enforce a right with knowledge or reason to know that the right does not exist;

427.104(1)(k) Use a communication which simulates legal or judicial process or which gives the appearance of being authorized, issued or approved by a government, governmental agency or attorney-at-law when it is not;

427.104(1)(L) Threaten action against the customer unless like action is taken in regular course or is intended with respect to the particular debt; or

427.104(1)(m) Engage in conduct in violation of a rule adopted by the administrator after like conduct has been restrained or enjoined by a court in a civil action by the administrator against any person pursuant to the provisions on injunctions against false, misleading, deceptive or unconscionable agreements or conduct (ss. 426.109 and 426.110).

427.104(2) If a debt collector is not otherwise in violation of sub. (1) (j) with respect to a consumer credit transaction with a debtor, it is not a violation of this section to send a billing statement or other notice of account to, or to collect the amount due on the account from, the spouse of that debtor, if notice to the debtor’s spouse is provided under s. 766.56.