Photo credit: Getty Images. Effective dunning messages can make the difference between a patient who pays and one who delays or never pays.
Improving patient collections with effective dunning messages
By Keshav Bhat, MS, OD
August 20, 2025
In optometry, providing excellent care is only half the equation. Getting paid on time is just as important to keep your practice thriving. Yet many of us face the challenge of delayed or missed payments from patients.
One tool that’s often overlooked but highly effective in managing your revenue cycle is the dunning message—the short note on patient billing statements that explains account status and payment expectations.
What is a Dunning Message and Why Does it Matter?
A dunning message is a short, clear statement on a bill that lets patients know their account status—whether it’s a first notice, a reminder or a final demand for payment. Our services often involve both medical and vision insurance, so patients can easily get confused about what they owe. An effective dunning message removes ambiguity, strengthens your professionalism and makes it more likely you’ll get paid—without alienating patients.
5 Proven Dunning Messages You Can Adapt for Your Practice
Detailed first notice: Use this with the initial statement. Try: “The personal balance on this statement is now your responsibility. Insurance has been applied to the total amount. Please remit payment to the address below.” This message works because it’s professional, direct and informative. It doesn’t assume the patient understands the billing process and avoids emotional language. It’s especially helpful after comprehensive eye exams that involve both refraction and medical care.
Simple first notice: For minimalism or broad demographics, a shorter message may be better: “You have a balance due. Please contact our office at [phone/email] with any questions.” This one is concise and patient-friendly. Including contact information shows you’re open to communication, though be prepared for increased calls. A secure patient portal for questions can help reduce your staff burden.
Eye-catching past due notice: When a payment is overdue, tone and visual design are important: “PAST DUE: Your account is overdue. Please remit payment immediately or contact us to discuss your options.” Color, bold fonts and smart placement make this message impossible to miss. It keeps things professional while prompting action. This message works well when patients delay paying for glasses or contact lenses after insurance has settled.
Blunt third notice: By the third statement, you need clarity and urgency: “You have not responded to our previous notices. Your balance is still unpaid.” This approach cuts through the noise. After two earlier attempts, brevity and emphasis—such as bold or red text—create urgency without being harsh.
Final notice before collections: Before sending an account to collections, give patients one last chance: “FINAL NOTICE: Your account is severely past due. Payment must be received by [date] to avoid referral to collections.” This explains the next step clearly and gives the patient a final opportunity to resolve the issue. It’s vital for maintaining goodwill before escalating the situation.
How to Implement These Messages in Your Practice
Segment your statements by patient status. Use software or a billing service that lets you add custom messages. Design with intention: Choose fonts, colors and layouts that match your brand but emphasize urgency where needed. Be consistent but flexible—maintain a professional tone but adjust your language for patient demographics. Train your staff so your team understands the messaging and is ready to answer questions. Monitor your results. Track payment rates and adjust your messaging as needed.
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The Bottom Line: Dunning Messages Drive Revenue and Experience
Today’s health care landscape is more complex than it’s ever been, especially in optometry. Higher out-of-pocket costs, multiple types of insurance and confusion over covered services mean patients often delay or avoid paying because they don’t fully understand what they owe.
Dunning messages aren’t about punishing patients. They’re strategic communication tools that guide patients toward payment with clarity, professionalism and empathy.
Consider this: More than 46 million Americans have at least one unpaid medical bill that’s gone to collections. One-in-five insured patients still struggles to pay medical bills.1 In optometry, a large share of unpaid bills come from misunderstandings—not unwillingness. This isn’t just a billing issue. It’s a patient experience issue.
Every interaction, including billing statements, reflects the values and professionalism of your practice. If patients receive confusing or repetitive notices, they’re more likely to ignore them. When they see a well-crafted, stage-appropriate dunning message—whether it’s a gentle reminder or a final firm notice—they’re more likely to understand, respond and pay.
References
1. KFF Health Care Debt Survey. (2022, June 16). Americans’ Challenges with Health Care Debt: Evidence from the KFF Health Care Debt Survey.
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Keshav Bhat, MS, OD, is the owner of Union Family Eye Associates in Charlotte, N.C. To contact him: drbhat@unionfamilyeye.com
