The risk of patients not paying their account balances resulting in bad debt expense remains a reality today. The Affordable Care Act insurance exchange coverage provisions that most individuals purchase do not cover 100% of medical charges. Currently, a potential economic downturn caused by overall inflation and / or a recession will not help this scenario. Employers continue to revise their medical benefit insurance plans to have larger out-of-pocket amounts, deductibles, and co-pays by employees to offset expenses. Research and discuss some best practices healthcare organizations are using today to improve their patient liability or balance due collection process.