Linda - our clients have patients who have seen the doctor maybe 4 or 5 times over the course of a year and have paid only the co-pay and nothing else. It doesn't happen often, but it does happen that the doctor says he will not see the patient again until they have either paid something against their balance, or paid it in full.Note that this is not the same as dismissing the patient. The doctor is not dismissing the patient (a procedure that has rules to be followed, as you noted). The doctor is simply saying he will see the patient again only after they have paid something/everything toward what they owe him. It is OK for the doctors to remind patients, when necessary, that they don't work for free.