DOCUMENT OVERVIEW : It is important that your office politely and effectively communicate with patients regarding balances. This document may be used early in the patient billing cycle as a reminder of outstanding fees for services rendered. Courteous and timely patient billing procedures often result in timely payment and a reduced accounts receivable




A review of our unpaid accounts indicates that you have an overdue balance of [$—].

You may use the enclosed preaddressed stamped envelope to send us a check or to provide credit card information to pay off the outstanding balance. Alternatively, please contact us at [telephone number] and provide us your credit card information over the telephone in order to transfer your balance.

If you have any questions, please call. We value you as a patient.




This document is provided to you as a courtesy by PGM Billing, a full service medical billing company.

This document is free to use it for personal or office use; however, may not be reproduced, transferred, sold, used for financial gain, or circulated in the public domain, without prior written authorization from

PGM Billing.