Patient Balance Negotiated Payment Collection Notice

DOCUMENT OVERVIEW: This  document  may   used  to   negotiate   patient  balances   prior   to   forwarding   to   collections   or   legal   counsel.
[inside address]
Dear [name]:
Our attempts to collect your debt of [$—] have brought no response. Your account is scheduled to be turned over to our legal councel in [—] days.
We are willing to settle the disputed account [$—]. By paying [$—] within [—] days of receipt of this letter, you will avoid legal action and the possiblity of credit rating impairment. A preaddressed stamped envelope is enclosed.
Yours truly,