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Medical (Patient) Payment Plan Agreement

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Medical (Patient) Payment Plan Agreement

Updated June 30, 2022

A medical payment plan agreement is a written agreement for any patient who has received health care services and agrees to pay their balance due over a period of time. The document may be used for a wide range of services from a standard doctor’s visit to voluntary or involuntary surgery.

A medical payment plan usually does not have interest attributed to the amount owed unless the balance goes unpaid and is forwarded to a collection agency. Payment is usually required to be made automatically on a monthly basis via a bank (ACH) or credit card.

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