Successful Self-Pay Revenue Generation: An Overview

A physical therapist smiling while managing paperwork.

Running a physical rehabilitation therapy practice can be incredibly rewarding. Helping people and providing a service that improves the lives of patients is why most people get into this business. Keeping a clinic afloat, however, requires more than just an altruistic passion for serving others. You need to take care of your bottom line, so you can continue to provide great care and have the freedom to leverage future growth opportunities.

While payments through insurance claims create their own set of problems, for many clinic owners and managers mismanagement of self-pay patients can also be a pitfall on the path to a flourishing practice. Some clinics fail to recognize the importance of self-pay patients and create a policy to encourage these patients. Others often neglect to establish adequate payment conventions that efficiently and conveniently collect fees. There are many reasons occupational, speech, and physical therapy practices often struggle with self-pay patients, but luckily there are a few easy steps that can you can take to simplify self-pay patient conventions and put your practice on the path to success.

Establish a specific self-pay policy

There are several reasons a patient may elect to self-pay for services, and it will be a major factor in the revenue model of any clinic. A patient may simply be outside their insurance coverage or have already hit limits for the year and for many uninsured or underinsured patients, out-of-pocket expenses are just a constant part of access to care.

Creating a comprehensive policy for self-pay patients not only creates a better standard of care by outlining payment expectations clearly from the first appointment but also reduces wasteful time tracking and chasing payments. A detailed, yet intuitive self-pay policy gives you more tools to run a successful practice, while also leaving patients more satisfied with no surprise costs or stressful payment systems.

Anticipating problems

Creating a well-established plan and policy for self-pay patients creates a roadmap for the future of your revenue stream. Using experience from problems encountered in the past, your policy can be comprehensive to prevent routine snags in the self-pay process. Outlining the process in detail can also serve as a tool to anticipate unknown issues and establish mechanisms to solve future problems.

Controlling cash flow

Maintaining a healthy cash flow is absolutely essential to cultivating a successful therapy practice. Even when revenue projections look promising, however, slowdowns in insurance claims and self-pay accounts can create gaps and delays in cash flow. Insurance claim delays can be difficult to manage but are possible. Your cash flow with self-pay patients though is well within your control to regulate.

Tracking self-pay accounts receivable and holding patients accountable to payment schedules is a huge time investment, and can result in a high number of non-payments or late payments. Standardizing this system with one self-pay policy can inform patients of simple requirements, eliminating time-wasting miscommunications. Incorporating a credit card processing system into your policy can offer patients a convenient way to pay, while also ensuring that neglected payments or bounced checks are solved as simply as processing the card on file.

Attracting new patients

Most self-pay patients understand that expenses will come with care. Your self-pay policy can be a way to attract self-pay appointments that are not only discerning about the cost of therapy but also want costs and expectations clearly outlined from the start. This can be a unique opportunity for marketing, as you can easily offer discounts for self-pay patients or competitive pricing plans if you choose.

While many self-pay patients are augmenting insufficient insurance coverage with out-of-pocket expenses, many have no insurance at all. According to the CDC, 32.8 million Americans do not have health insurance coverage. For many of these uninsured, this doesn’t mean they don’t receive medical care. Many people have complex situations that have caused a gap in their healthcare coverage or choose to go without and understand that treatment and therapy will come with an expense. This is a huge market and creating a competitive self-pay policy not only can gain your practice new patients but can retain them for down the line when they may choose to have medical insurance.

Communicate expectations thoroughly

The biggest advantage of a self-pay policy is its transparency and simplicity from a patient perspective. Most issues with self-payment systems arise from miscommunication and misunderstanding. Outlining all patient responsibilities from the start minimizes the risk of any missed payment dates or other costly problems.

With a standardized, comprehensive self-pay policy, you can offer patients the ease of fully transparent requirements and expectations. With well-developed self-pay systems, patients can even receive auto-generated reminders or have payment schedules available to access on your website. Convenience and simplicity are huge assets when it comes to managing self-pay patients, and communicating expectations effectively is essential.

A senior man working with a physiotherapist.
The key to preventing nonpayment from self-pay patients is simply to communicate expectations early, clearly, and often.

Organize your systems

You can’t control how organized your patients are, but you can control how organized your practice is. Confusion and losses with self-pay systems typically boil down to disorganization, but robust organizational systems can simplify these issues. Design an infrastructure for your practice that hardwires organization into your revenue stream with proper software and tools. Common areas to look for inefficiencies within your revenue systems are:


With proper systems to standardize billing, self-pay patients can easily be separated from insurance claims. Standardized billing processes can be automatically applied for instant billing. Keeping this system concise and organized offers patients instant and convenient billing and saves valuable time in administrative work.


Establishing routing protocols for self-pay patients simplifies payment processes immensely. An online patient payment portal that accepts credit cards can take the stress off office personnel and offer patients more convenience which in turn reduces late payments.

Accounts receivable

Managing accounts receivable for self-pay patients can be annoying at best, catastrophic at worst as a disorganized system could cause expensive oversights in bookkeeping. A well-organized solution could tie this to customer payments to automate the accounts receivable process, limiting human error and saving time.

Patient contact

With a well-established and organized system for self-pay patients, patient contact becomes much easier. Leaving another follow-up voicemail for a patient reminder just isn’t an efficient way to chase payment anymore. Stop chasing payments at all, and include a contact system in your infrastructure, allowing you to send reminders to patients and allowing them an efficient means to get in contact with you.


Surveying your current revenue situation can be difficult in the face of disorganization. A comprehensive solution to administrative organization streamlines reporting so that you can easily see exactly where you’re at with your accounts and your revenue and how you need to improve.

Modernizing payment systems

You may think that your payment system works fine, but if you’re not leveraging the advantages of technologies customized for the medical industry for payment systems, you’re likely wasting time chasing down payments and generating bills.

Most modern EMR software streamlines the payment process by tying all systems together in one interconnected infrastructure. With a modern solution like this, your system automatically alerts patients of a pending bill. Patients can log into the same patient portal that they schedule appointments on and take care of payment. This creates a virtual space where you can conduct business with patients with total control and organization.

Connecting your entire system to credit card processing ensures that you don’t waste time chasing down payments and reminding customers of bills. A secure system to hold credit card numbers on file immediately processes payment in case of a late bill or bounced check. This helps guarantee a steady cash flow and accurate reporting for your practice.

Solving the self-pay problem

Disorganized systems can be hard to operate using, but they are even harder to adequately glean information and compile reports from. A well-organized solution for your administrative systems and self-pay patient interactions can automatically generate powerful reporting that will tell you exactly where you’re at in your cash flow and revenue streams.

Your self-pay patients make up a significant portion of your practice, and you need to support and cater to them to achieve success. Establishing a detailed self-pay policy, communicating clearly, and organizing your systems can save time and money with your self-pay patients. If you have questions about how to provide a great self-pay environment for your practice, contact us today.

Here at A2C Medical, we’re experts at simplifying and standardizing medical systems for occupational, speech, or physical therapy practices, and we’d love to help. Our comprehensive EMR software is therapy-focused and a universal solution to many of the problems clinics face dealing with self-pay clients. Schedule a demo and see what A2C can do for you.


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