Patient Co-payments: What is your patient-liable risk?

Patient Co-payments: What is your patient-liable risk?

Patient liables – the part of the claim your patient is responsible for paying – have become the norm, and are becoming even more prevalent. In today’s tough economic times, and with the large medial aid contribution increases set for 2017, these amounts will become increasingly more challenging for patients to pay.We looked at the patient-liable amounts of General Practitioners (GPs) and Specialists, and what proportion makes up the overall claims.

Here’s what we found:


The graph shows that both GPs and Specialists see an increase in their patient risk profile towards the end of the year, with GPs having a higher percentage of patient-liable claims. However, in rand terms, GPs have an average annual patient-liable amount of R163 000 per practice, whereas the corresponding value for Specialists is much higher, at around R609 000 per practice.

Why is knowing your patient liable risk important?

The problem with patient liables is that many practices don’t have the processes in place for effective collection from patients – especially directly after the consultation. This is particularly important as the chance of collecting from a patient drops by around 16%* as soon as they leave the practice.

If you are struggling to get your patient-liable amounts paid, try the following simple measures:

• Tip #1: Tell patients immediately how much they owe
Don’t send invoices after the consultation, because by then there is little sense of urgency for the patient. Check patient benefits before the consultation, so you can inform patients of any shortfalls even before the appointment

• Tip #2: Make your invoices clear and simple
Make invoices easier to understand, so that there’s less tendency for patients to put them aside for later

• Tip #3: Offer patients convenient payment methods
Provide as many payment options as possible, so that the most likely patient response is to pay rather than delay


With the rising costs of medical-aid plans, you can expect an increase in risk of payment of your patient liables and an even bigger risk as the year progresses. It is therefore essential you understand your patient-liable risk profile, and ensure your practice has the correct processes in place to collect money outstanding before the patient leaves the practice.

Ferkovic, T.J. (2016) Waiving copays puts you at risk for fraud. Available at: (Accessed: 26 October 2016).

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