Patient Responsibility Labels

Medical Office Patient Responsibility Collection Labels are a fast and convenient method for communicating messages to your patients. The bright colors of the Patient Responsibility Collection Labels are sure to catch your patients' attention and effectively communicate the message. With a large variety labels to choose from, we have the right collection labels for your private practice, medical office or faculty. Varying in tone from friendly reminders to more direct requests for past due and final notice payments, these billing stickers will respectfully inform your patients the amount they owe after insurance has paid their portion.

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Stock No. Description Color Size UOM Unit Purchase
INS. NOT PAID   250/RL
INS. NOT PAID 250/RL
MAP1560
WE HAVE NOT BEEN PAID ON THIS CLAIM BECAUSE YOUR INSURANCE COMPANY: *SENT PAYMENT TO YOU *APPLIED THESE CHARGES TO YOUR FLUORESCENT CHARTREUSE 3-1/4"W x 1-3/4"H 250/ROLL
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CO-PAY AMOUNT   250/RL
CO-PAY AMOUNT 250/RL
MAP2050
THIS AMOUNT IS YOUR CO-PAY. PLEASE PAY AT TIME OF SERVICE IN THE FUTURE. FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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AMNT DUE BY YOU  FL-RED 250/RL
AMNT DUE BY YOU FL-RED 250/RL
MAP2090
MEDICARE HAS PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT PAYABLE DIRECTLY BY YOU TO US. PLEASE REMIT FLUORESCENT RED 1-1/2"W x 7/8"H 250/ROLL
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INEED INFO   250/RL
INEED INFO 250/RL
MAP2100
IN ORDER TO PROCESS YOUR CLAIM YOUR INSURANCE COMPANY NEEDS INFORMATION PLEASE CONTACT THEM OR SEND US PAYMENT IN FULL� FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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YOUR INS NOT PD   250/RL
YOUR INS NOT PD 250/RL
MAP2120
YOUR INSURANCE CO. HAS NOT PAID THIS CLAIM BECAUSE: *DEDUCTIBLE TAKEN *NONCOVERED SERVICE *INSURANCE CANCELED *REQUESTE FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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FINAL 10DAYS   250/RL
FINAL 10DAYS 250/RL
FINAL NOTICE YOUR PAYMENT MUST BE RECEIVED WITHIN 10 DAYS OR IMMEDIATE ACTION WILL BE TAKEN.
MAP2130
FINAL NOTICE YOUR PAYMENT MUST BE RECEIVED WITHIN 10 DAYS OR IMMEDIATE ACTION WILL BE TAKEN. FLUORESCENT RED 1-1/2"W x 7/8"H 250/ROLL
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PAY IN FULL   250/RL
PAY IN FULL 250/RL
MAP2140
THIS BALANCE IS YOUR INSURANCE CO-PAY. PLEASE PAY IN FULL. FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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INS PAID YOU OWE   250/RL
INS PAID YOU OWE 250/RL
MAP2200
YOUR INSURANCE COMPANY HAS ALREADY PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT YOU OWE. FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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REMINDER RFRL FL-GRN 250/RL
REMINDER RFRL FL-GRN 250/RL
MAP2250
REMINDER PATIENT NEEDS REFERRALS FROM PRIMARY PHYSICIAN FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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INS COVERAGE   250/RL
INS COVERAGE 250/RL
MAP3710
PLEASE… LET US KNOW IF YOU HAVE INSURANCE COVERAGE FOR THESE SERVICES. IF NOT, THE BALANCE SHOWN IS NOW DUE. FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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BALANCE IS DUE   250/RL
BALANCE IS DUE 250/RL
MAP3720
YOUR BALANCE DUE TO: *YOUR DEDUCTIBLE *NON-COVERED SERVICES *CO-PAY $___ FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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NEW INS COVERAGE   250/RL
NEW INS COVERAGE 250/RL
MAP3740
NEW INSURANCE COVERAGE? NOTIFY US IMMEDIATELY IF YOUR INSURANCE HAS CHANGED. SEND US THE ID AND GROUP #'S, PHONE NUMBE Light Blue 1-1/2"W x 7/8"H 250/ROLL
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INS PENDING   250/RL
INS PENDING 250/RL
MAP3750
INSURANCE PENDING $___ AMOUNT DUE NOW $___ FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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PLEASE REMIT   250/RL
PLEASE REMIT 250/RL
MAP3770
YOUR INSURANCE COVERED ALL BUT THE AMOUNT SHOWN ON THIS STATEMENT. MAY WE PLEASE HAVE YOUR REMITTANCE BY RETURN MAIL. FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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INFOR OUR OFFC   250/RL
INFOR OUR OFFC 250/RL
MAP3790
IF YOU ARE COVERED BY ANY INSURANCE PROGRAM INCLUDING MEDICARE OR MEDICAID PLEASE INFORM OUR OFFICE IMMEDIATELY. FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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YOUR BLNC DUE   250/RL
YOUR BLNC DUE 250/RL
MAP3810
YOUR INSURANCE HAS BEEN BILLED FOR YOU. YOUR SHARE OF THIS BALANCE IS $___ FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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SHOULD WE BILL INS LBL 250/RL
SHOULD WE BILL INS LBL 250/RL
MAP3840
SHOULD WE BE BILLING YOUR INSURANCE FOR ALL OR PART OF THIS BALANCE? IF SO, PLEASE CALL OUR OFFICE. Light Blue 1-1/2"W x 7/8"H 250/ROLL
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PAY BLNC FULL FL-PNK 250/RL
PAY BLNC FULL FL-PNK 250/RL
MAP3860
ALTHOUGH WE ARE WAITING FOR YOUR INSURANCE TO PAY, IT WILL NOT COVER YOUR BALANCE IN FULL. A PERSONAL PAYMENT ON YOUR� FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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MEDICARE PAID   250/RL
MEDICARE PAID 250/RL
MAP3870
MEDICARE HAS PAID ITS SHARE OF YOUR BILL. WE WOULD APPRECIATE PAYMENT FROM YOU FOR THE AMOUNT SHOWN ON THIS STATEMENT. FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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PAY IN 60 DAYS FL-GRN 250RL
PAY IN 60 DAYS FL-GRN 250RL
MAP3880
WE HAVE FILED YOUR INSURANCE CLAIM. IF CLAIM HAS NOT BEEN PAID WITHIN 60 DAYS, YOU ARE RESPONSIBLE FOR THE FULL AMOUNT� FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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INS CLAIM RJCTD   250/RL
INS CLAIM RJCTD 250/RL
MAP3900
INSURANCE CLAIM REJECTED YOUR CLAIM FOR BENEFITS HAS BEEN REJECTED BY YOUR INSURANCE COMPANY. THIS AMOUNT IS NOW DUE� FLUORESCENT RED 1-1/2"W x 7/8"H 250/ROLL
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REMIT BY MAIL  FL-PNK  250/RL
REMIT BY MAIL FL-PNK 250/RL
MAP3940
MEDICARE COVERED ALL BUT THE AMOUNT SHOWN ON THIS STATEMENT. MAY WE PLEASE HAVE YOUR REMITTANCE BY RETURN MAIL. FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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REMIT CO-PYMNT  FL-ORG  250/RL
REMIT CO-PYMNT FL-ORG 250/RL
MAP3950
YOUR CO-PAYMENT WAS NOT PAID BEFORE YOU LEFT OUR OFFICE. IN ACCORDANCE WITH STATE AND FEDERAL LAWS, YOU OWE ____ PLEASE FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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PATIENT RESP.   250/RL
PATIENT RESP. 250/RL
MAP3990
PATIENT RESPONSIBILITY DUE TO: *DEDUCTIBLE *NONCOVERED SERVICES *CO-PAYMENT PLEASE REMIT $___ AS SOON AS POSSIBLE. T FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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BILL YOUR RESP   250/RL
BILL YOUR RESP 250/RL
MAP4010
YOUR INSURANCE COMPANY DENIED THIS CLAIM BECAUSE YOU DID NOT RESPOND TO THEIR REQUEST FOR FURTHER INFORMATION. THIS BIL FLUORESCENT RED 1-1/2"W x 7/8"H 250/ROLL
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THNKS FOR PYMNT   250/RL
THNKS FOR PYMNT 250/RL
MAP4020
YOUR INSURANCE COMPANY HAS APPLIED THESE CHARGES TO YOUR DEDUCTIBLE. THANK YOU FOR YOUR PROMPT PAYMENT. FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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PAY BALANCE   250/RL
PAY BALANCE 250/RL
MAP4050
ALL INSURANCE CLAIMS HAVE BEEN PAID. YOUR REMAINING BALANCE IS OVERDUE. PLEASE PAY PROMPTLY TO AVOID COLLECTION PROCED FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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PLS REMIT BLNC   250/RL
PLS REMIT BLNC 250/RL
MAP4070
YOUR INSURANCE HAS BEEN BILLED AND CHARGES APPLIED TO DEDUCTIBLE. PLEASE REMIT BALANCE FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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INS PYMNT DUE FL-ORG  250/RL
INS PYMNT DUE FL-ORG 250/RL
MAP4090
INSURANCE PAYMNET OVERDUE PLEASE CHECK WITH YOUR CARRIER FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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ACCT NOW DUE   250/RL
ACCT NOW DUE 250/RL
MAP4100
YOUR INSURANCE COMPANY HAS SENT YOU PAYMENT OF ITS SHARE OF THIS BILL… YOUR ACCOUNT IS NOW DUE AND PAYABLE. FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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SERV NOT CVRD   250/RL
SERV NOT CVRD 250/RL
MAP4110
THESE SERVICES ARE NOT COVERED BY YOUR INSURANCE FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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PARTIAL BILLING LBL 250/RL
PARTIAL BILLING LBL 250/RL
MAP4120
PARTIAL BILLING ADDITIONAL CHARGES PENDING INSURANCE. Light Blue 1-1/2"W x 7/8"H 250/ROLL
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CO-PYMNT SERV  FL-GRN 250/RL
CO-PYMNT SERV FL-GRN 250/RL
MAP4130
YOUR INSURANCE REQUIRES THAT CO-PAYMENT BE PAID AT TIME OF SERVICE. FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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REMIT PYMNT FL-GRN 250/RL
REMIT PYMNT FL-GRN 250/RL
MAP4140
PLEASE CHECK WITH YOUR INSURANCE COMPANY ABOUT THIS ACCOUNT… OR REMIT PAYMENT TO US. FLUORESCENT GREEN 1-1/2"W x 7/8"H 250/ROLL
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INS TERMINATED   250/RL
INS TERMINATED 250/RL
MAP4150
YOUR INSURANCE COVERAGE HAS BEEN TERMINATED. PLEASE PAY IN FULL OR CALL TO SET UP A PAYMENT SCHEDULE. FLUORESCENT ORANGE 1-1/2"W x 7/8"H 250/ROLL
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INS TO DEDUCT.   250/RL
INS TO DEDUCT. 250/RL
MAP4160
YOUR INSURANCE COMPANY HAS APPLIED THESE CHARGES TO YOUR DEDUCTIBLE FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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PAST DUE OPTNS   250/RL
PAST DUE OPTNS 250/RL
MAP4170
PAST DUE *YOUR INSURANCE HAS PAID ITS SHARE. *DON'T JEPORIDIZE YOUR CREDIT. *PLEASE REMIT TODAY! FLUORESCENT CHARTREUSE 3-1/4"W x 1-3/4"H 250/ROLL
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PAT. RESP. DUE   250/RL
PAT. RESP. DUE 250/RL
MAP4180
PATIENT RESPONSIBILITY DUE TO: *DEDUCTIBLE *NONCOVERED SERVICES *TOO MANY SERVICES IN TIME PERIOD *MAXIUMUM BENEFIT ALLO FLUORESCENT RED 3-1/4"W x 1-3/4"H 250/ROLL
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INS. CO. PAID   250/RL
INS. CO. PAID 250/RL
MAP4200
YOUR INSURANCE COMPANY HAS PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT PAYABLE DIRECTLY BY YOU. FLUORESCENT PINK 3-1/4"W x 1-3/4"H 250/ROLL
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NOTICE BLNC DUE  FL-CHR 250/RL
NOTICE BLNC DUE FL-CHR 250/RL
MAP5520
YOUR INSURANCE CARRIER HAS RECEIVED A COPY OF THIS BILL YOU WILL BE NOTIFIED OF ANY BALANCE DUE, UPON RECEIPT OF PAYM FLUORESCENT CHARTREUSE 1-1/2"W x 7/8"H 250/ROLL
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MEDICARE PAID  FL-PNK 250/RL
MEDICARE PAID FL-PNK 250/RL
MAP5560
MEDICARE HAS PAID ITS SHARE OF YOUR BILL. PLEASE ADVISE US OF ANY ADDITIONAL INSURANCE INFORMATION OR PAY THIS AMOUNT I FLUORESCENT PINK 1-1/2"W x 7/8"H 250/ROLL
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INS NOT PD. CLAIM   250/RL
INS NOT PD. CLAIM 250/RL
MAP5580
YOUR INSURANCE CO. HAS NOT PAID THIS CLAIM BECAUSE: *DEDUCTIBLE TAKEN *NONCOVERED SERVICE *INSURANCE CANCELED *REQUESTE FLUORESCENT CHARTREUSE 3-1/4"W x 1-3/4"H 250/ROLL
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INS/PCP/ID#   250/RL
INS/PCP/ID# 250/RL
MAP5600
INSURANCE___ PCP___ I.D.#___ EFF.DATE___ CO-PAY___ DEDUCTIBLE___ [ ] REFERRAL NEEDED FLUORESCENT GREEN 3-1/4"W x 1-3/4"H 250/ROLL
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REMINDER OPTIONS   250/RL
REMINDER OPTIONS 250/RL
MAP5620
REMINDER *YOUR INSURANCE HAS PAID ITS SHARE *THIS IS THE AMOUNT THAT YOU OWE. *PLEASE REMIT TODAY! FLUORESCENT GREEN 3-1/4"W x 1-3/4"H 250/ROLL
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FINAL NOTICE   250/RL
FINAL NOTICE 250/RL
MAP5630
FINAL NOTICE *YOUR INSURANCE HAS PAID ITS SHARE. *IF WE DO NOT HEAR FROM YOU WITHIN___DAYS, THIS ACCOUNT WILL BE TURNED FLUORESCENT RED 3-1/4"W x 1-3/4"H 250/ROLL
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AMOUNT YOU OWE   320/RL
AMOUNT YOU OWE 320/RL
UL1423
YOUR INSURANCE COMPANY HAS PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT PAYABLE DIRECTLY BY YOU. PLEA FLUORESCENT RED 3"W x 7/8"H 320/ROLL
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CONT HOUNDING YOU   420/RL
CONT HOUNDING YOU 420/RL
UL520
WE HATE TO KEEP HOUNDING YOU, BUT YOUR BILL IS PAST DUE. FLUORESCENT PINK 2-1/4"W x 7/8"H 420/ROLL
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