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Should practices collect patient payments upfront?

Yes, where the estimate is reliable. Collection rates on patient balances after the visit are poor, and upfront collection is the single most effective way to raise them. The condition is accuracy: collecting on a rough estimate creates refunds and complaints, so the practice needs CPT-level benefits verification and a fee schedule applied before it asks for money.

Upfront collection also changes patient behaviour. Patients with a clear number are less likely to cancel at the last minute and more likely to show, because the financial conversation already happened. The practices that struggle with upfront collection are usually the ones whose numbers are wrong often enough that staff stop trusting them.

Last reviewed October 8, 2026

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