If we are doing patient billing then we consider ALL monies collected by the office when determining our fees, since we are required to input and track all patient payments to make sure patient balances are accurate. For example, if we are doing full practice management including patient responsibilities then we have to record and track all payments made whether they are made in the office at the time of service or sent in the mail. Many patients pay their balances in the office at an appointment. It is impossible to separate money collected at the time of the visit that was not prompted by a bill vs money collected at the visit from a bill they received vs money sent in. Also, many patients suddenly begin paying their patient responsibility at their visit once they realize they will be billed.