I like how Vinny does it. You're right scslmd. We are way too compassionate. If they are Medicaid, it's paid. If they have private insurance, almost all is paid unless deductible; and that was their choice (as hard as it is to purchase insurance these days). If they are self pay, well then they should pay. We give them 30% off anyway -- paid at time of service. I don't know why we should be the only business that allows customers to run up such huge bills. We should insist on payment and, if not, not see them.
Of course, the hardest part is we all have our patients we really like seeing; and if it's one for all and all for one, then we risk losing them.