Mailing a Refund Check To Patient
Due To Their Overpayment

Dr. Name
Office address
City, State ZIP
(or preferably print on letterhead)


Patient Name
Patient Address
City, State  Zip

Dear ____:

Analysis of your account shows that you made a personal payment prior to an insurance payment and a contractual insurance adjustment.  This has resulted in a credit balance on your account.

Enclosed please find a check in the amount of $[xxx.xx].     



Jane Doe
Financial Coordinator for Dr._____