Outstanding Patient Payments: How to Keep Control

Outstanding patient payments are controlled with three habits: every service provided has its invoice, what has not been collected is visible by patient and by age, and collecting it is easy when the patient comes back to reception. Without that, the debt is discovered late, when it is already harder to talk about.

Where outstanding payments come from

An outstanding payment appears when what was provided and what was collected come apart. It happens in situations like these:

• Partial payment. The patient pays a part and the rest is left for the next visit.
• Deferred payment. The treatment is invoiced and it is agreed that it will be paid later.
• Oversight at reception. The session ends, there is a queue and the patient leaves without going to the till.

The first two are agreements; the third is an oversight. All three have something in common: as long as there is no issued invoice, the debt is not seen as debt. In Mi Clínica, only issued invoices with an uncollected amount count as debt. A draft invoice does not count, and neither does a cancelled one.

Bear in mind when an invoice is issued in Mi Clínica: when its payment is recorded, even if partial, when an accepted quote is converted into an invoice, or when you press “Emitir factura” (Issue invoice) on the draft. If the patient leaves without paying anything, the invoice for that session, if you have prepared one, stays as a draft and out of “Deudores” (Debtors) until you issue it. That is why the weekly routine includes reviewing drafts.

See what is outstanding at a glance

What is outstanding needs to be visible in three places: a list of debtors, each patient’s record and the day’s alerts. In Mi Clínica it works like this:

Where	What you see
“Facturación” (Invoicing), “Deudores” tab	One patient per row, from highest to lowest debt: what they owe, their outstanding invoices, the age of the oldest one and the buttons to make contact and record the payment. The tab shows the number of debtors.
Patient record	The balance in the summary and, in its invoicing tab, the total invoiced, collected and outstanding.
Alerts	An outstanding payment or partial payment alert for each issued invoice with an uncollected amount, with the access to record the payment.
“Facturación”, at the top	What is outstanding for the whole clinic, calculated on all issued invoices, and how many invoices are still in draft.

Look at age before amount: a small debt from two months ago deserves more attention than a large one from yesterday, because the more time passes, the harder it is to raise the subject. In the list of debtors, the age changes colour once it passes 7 days and again once it passes 30.

Who sees it? Invoicing and the patient’s balance are visible to the “Recepción” (Reception), “Administración” (Administration) and “Dirección” (Management) roles; healthcare practitioners, by default, do not see them. How access to the clinical side is divided we explain in who can see the medical record.

Collect what is owed without awkwardness

The natural moment to collect a debt is when the patient comes back: they are at reception, they have their next appointment and the conversation is short. For that, whoever is serving them needs to know that something is outstanding before the patient leaves.

In Mi Clínica, the “Registrar cobro” (Record payment) button in the list of debtors opens the payment with the patient already selected and, if they have only one outstanding invoice, with that invoice ticked. The outstanding payment alert has the same access. You enter the amount and the method (cash, card, Bizum (a Spanish mobile payment app), bank transfer or others) and the payment is recorded against its invoice.

Some tips that help at the counter:

• Say what the outstanding amount is for: “the rest of the invoice for your last session is still to be paid” is understood better than “you have something outstanding”.
• Offer the payment methods you accept, without assuming the patient is carrying cash.
• If they cannot pay at that moment, agree a date and note it where your team will see it.

Mi Clínica has no online payment: the patient pays at the clinic, by Bizum or by bank transfer, and the payment is recorded in the program.

Partial payments and instalments

A partial payment is not a problem if it is recorded against its invoice. In Mi Clínica each payment can be full or partial: when you record a part, the program tells you how much will remain outstanding, and the invoice stays as partially paid until it is completed. You can never collect more than the invoice total.

If you agree with the patient to pay for a treatment in instalments:

• Put the agreement in writing: total amount, number of instalments and dates.
• Record each instalment when it is paid, with its method.
• If any of the instalments is in cash, bear in mind that, for the legal limit on cash payments in Spain, all the payments into which a single service is split are added together. We explain this in cash control in a clinic.

How to remind a patient of a debt

In private, with specific details and through a channel the patient uses. A call or a conversation at the next visit is the most direct; what is best avoided is talking about the debt in front of other patients or leaving the detail to someone else who picks up the phone.

In Mi Clínica, the “Contactar” (Contact) button in the list of debtors shows the patient’s phone number and email address along with what they owe and for which invoices. Automatic reminders to the patient by email, SMS or WhatsApp are still being switched on and are not sent yet: the reminder is done by your team.

A weekly routine so it does not pile up

A short review each week prevents what is outstanding from growing without anyone seeing it:

1. Open the list of debtors and start with the oldest debts.
2. Review draft invoices, which do not count as debt. In Mi Clínica a draft is issued when its payment is recorded; if it is surplus, discard it: a draft has no number and discarding it leaves no gap in the series.
3. See which patients with a debt have an appointment this week and flag it at reception.
4. Check that the total outstanding goes down from one week to the next.

During your Mi Clínica trial, record a partial payment on an invoice and see how the remainder appears in “Deudores”, in the patient’s record and in the alerts. If you prepare quotes before treating, in treatment quotes in a clinic we explain how they become invoices; the rest of the features are on the Mi Clínica page (in Spanish).

Sources consulted

Checked on 11 October 2026. We link to the original source so that you can consult the current text.

• Ley 7/2012, de 29 de octubre, de modificación de la normativa tributaria y presupuestaria y de adecuación de la normativa financiera para la intensificación de las actuaciones en la prevención y lucha contra el fraude (texto consolidado). BOE.