Once insurance payments have been posted the next process is to generate patient statements for outstanding balances due such as deductible, co-pay or co-insurance. The statement cycle includes two statements and a final notice. If there is still no response to the final notice a courtesy phone call is made to the patient to attempt to collect the outstanding balance. Once our efforts have been exhausted the accounts are turned over to an outside collection agency upon client approval. If client decides to not use a collection agency the balances are written off as a bad debt adjustment to keep accounts receivable clean and current.