Patient payments for medical and dental practices

Practices that collect well usually do three things: take payment (or a deposit) from cash patients at the time of the visit, tell medical aid patients upfront what they may owe for shortfalls and co-payments, and send any remaining balance immediately with a payment link rather than waiting for month-end statements. Treatment plans and orthodontics are best handled with a written payment plan collected by debit order. Throughout, protect patient information, which is special personal information under POPIA.

This guide covers the patient-payment side for GPs, specialists, dentists, physiotherapists, psychologists and other practices. It doesn't cover medical aid claim submission, which your practice management system and billing bureau handle.

Where practice revenue comes from

Collect at the point of care

The easiest balance to collect is the one the patient pays before they leave:

• Cash patients: quote before treatment and take payment at reception by card, or send a payment link that the patient pays in the waiting room.
• Deposits for longer procedures and for new patients booking high-value appointments.
• Estimated co-payments for procedures where the scheme's rate is known to be lower than your fee.

Explain fees upfront

Surprise shortfalls are the main cause of slow patient payments and complaints. Before treatment where possible:

• Tell patients whether you charge scheme rates or your own rates.
• Give a written estimate for procedures, including what the scheme is likely to cover.
• Explain who pays what, and when.

The Health Professions Council of South Africa (HPCSA) publishes ethical guidance on business practices and fees for practitioners; your professional association can advise on billing ethics for your profession.

Send balances immediately, with a payment link

When the scheme pays short, or pays the member instead of the practice:

1. Send the patient an itemised invoice or statement straight away.
2. Include a payment link (card or instant EFT) and EFT details with a unique reference.
3. Follow up with a reminder after 7 and 14 days.
4. Call the patient if still unpaid after 30 days, and offer a payment arrangement.

Invoices sent weeks later, on a monthly statement, are paid far less reliably. See how to reduce late payments.

Payment plans for treatment

For orthodontics, implants, fertility treatments or therapy programmes:

• Agree a written plan: total fee, deposit, number of instalments, dates.
• Collect instalments by debit order, with a mandate signed by the account holder (often a parent). See how debit orders work.
• State what happens if treatment stops early or instalments are missed.
• If you charge interest or fees on instalments, check whether the National Credit Act applies.

Protecting patient information

Health information is special personal information under POPIA, with stricter conditions. In billing:

• Don't include diagnoses or procedure details in email subject lines or SMS messages.
• Send invoices only to the patient or the responsible account holder.
• Limit which staff can see clinical and financial data.
• Make sure your billing and payment providers act as operators under written agreements.
• Use two-factor authentication on practice systems.

See our colleagues' guide to POPIA payment data compliance.

Reconciling payments

Practices receive money from schemes, patients, billing bureaux and card machines. Keep it manageable:

• Record each receipt against the specific invoice (scheme payments against claims, patient payments against balances).
• Use unique references for patient EFTs. See payment reference best practice.
• Reconcile at least weekly (see reconcile EFT payments).

Reports for practice managers

• Patient balances by age (30, 60, 90+ days).
• Revenue split by scheme payments and patient payments.
• Collections on treatment plans vs schedule.
• Payment methods used by patients.

How CentraPoint helps

CentraPoint works alongside your practice management or medical billing system to handle the patient-payment side: invoices and statements with payment links, card and instant EFT through connected gateways, EFT with proof-of-payment upload, and Netcash debit orders for treatment plans with online mandate signing. Reminders run automatically, roles and permissions restrict access, and authenticator-app 2FA protects accounts. It doesn't submit medical aid claims. See the payment links docs or contact us.

Frequently asked questions

How can a medical practice reduce outstanding patient balances?

Collect from cash patients at the visit, explain likely shortfalls upfront, and send remaining balances immediately with a payment link, followed by consistent reminders.

What if the medical aid pays the patient instead of the practice?

The patient remains responsible for paying the practice. Send an invoice with a payment link as soon as you know the scheme has paid the member, and follow up promptly.

Can a dental practice collect treatment instalments by debit order?

Yes. Agree a written payment plan and collect instalments by debit order with a mandate signed by the account holder. Check whether the National Credit Act applies if you charge interest or fees.

What patient information can appear on an invoice?

Include what's needed to identify the service and the account, and send it only to the patient or responsible person. Avoid putting diagnoses in email subjects or SMS messages, as health information is special personal information under POPIA.