Experiments in a community mental health center: increasing client payments for outpatient services

Although public health care systems often depend on revenue generated from client payment for services, inadequate agency fee payment systems continue to create substantial administrative problems. The first study examined the effects of implementing a system for producing and maintaining routine client fee payment. The second study was a replication of the first study. The Credit Criterion System was designed to: (a) allow clients to establish intra-agency credit by paying cash for each of the first three visits; and (b) pay for services monthly after credit was established. The system resulted in a baseline collection rate of 20%, compared with the Credit Criterion rate of 96.6%. The Credit Criterion System did not create additional administrative costs and it had no effect on attendance. Thus, the Credit Criterion System appears to be a reasonable set of procedures for allowing clients to meet their financial obligations to an agency.