Past Due Invoice Letter Template for NEMT: Reminder, Second Notice, and Final Notice

An unpaid invoice is a ride you already gave. A late facility bill is often not a refusal. It can be a missing purchase order, an invoice sent to the wrong desk, or a charge nobody approved. Three short letters, sent on a steady schedule and written into a contact log, give you the best chance of being paid and a clean record when you are not.

This set is for facilities and for riders or families who agreed to pay. It is not for Medicaid. When a broker or health plan owes you for a trip, you fight a denial with the claim appeal letter template, and a Medicaid member never gets any of these letters for a covered ride. The routine behind the letters is in NEMT collections. This page gives you the letters themselves.

How to use this template

1. Check who owes the money. The invoice must be for rides the facility, the rider, or the family agreed to pay. If the rider has Medicaid for that ride date, or gets coverage that reaches back to it, stop and bill Medicaid. NEMT collections explains how to check.
2. Fill in Parts 1 and 2 from the signed agreement. Copy the due date, the late fee, the days to fix a missed payment, and the way notices must be sent. The facility transportation agreement has a place for each in Parts 7, 14, and 15 and Schedule B. The NEMT service agreement has the due date and the days after which new rides wait, in Part 6. With no signed agreement, write “none” and leave out the late fee and any stop date.
3. Send Letter 1 about 15 days after the due date. Attach a copy of each invoice, and send it to the billing contact the agreement names. Fifteen days is a common habit, not a legal deadline. The agreement’s terms come first.
4. Call within a week. Ask which rides, if any, the customer questions, and what date payment will arrive. Write the call in Part 6 the same day.
5. Send Letter 2 about 15 days after Letter 1, if the account is still open. Add a late fee only if the agreement allows it, and show the section number.
6. Send Letter 3 only when you will do what it says. Set its date from the agreement’s days to fix a missed payment. If the agreement names none, pick a date you can defend and write it on the letter.
7. Send each letter the way the agreement says, and keep proof of delivery. A tracking number, an email receipt, or a signed return receipt is enough.
8. Record every step in Part 6, and mark each payment in your payment log and your accounts receivable list when it lands. Stop the letters the day the account is paid.

The template

Part 1: Account details

Field	Write it here
Customer: facility’s legal name, or the payer’s full name
Who pays: the facility, the rider, or a family member who signed as the responsible party
Billing contact, title, phone, and email
Address the agreement or the payer chose for notices
Account number
Agreement signed on, and the date of the rate sheet or Schedule A
Payment due ___ days after the invoice date (agreement section ___)
Late fee or interest the agreement allows (section ___), or “none”
Days the customer has to fix a missed payment before you may pause rides (section ___), or “none”
How the agreement says notices must be sent: mail, email, or both
Medicaid check for private-pay riders: date done, and result

Part 2: Past due invoices

Invoice number	Invoice date	Rides from and through	Amount	Due date	Days past due
Total

Part 3: Letter 1, the reminder

Send about 15 days after the due date.

[Your letterhead]

Date: ______________

To: ______________________________ (billing contact, title, and the facility or payer)

Account number: ______________

Subject: Reminder, invoices past due, $______________

Dear ______________:

Thank you for riding with [Company]. Our records show that the invoices below were due on ______________ and have not been paid.

Invoice number	Rides from and through	Amount	Due date

Total past due: $______________

Please send payment by ______________ [by check to ______________ / by card at ______________ / by bank transfer to the account on file]. If you already paid, tell us the date and how, and we will find it. If you question any charge, tell us the ride date and what is wrong by ______________, and pay the rest now.

[Facilities: If your accounts payable office needs a purchase order number or a different invoice format, tell us and we will send corrected copies the same day.]

Call ______________ at ______________ with any question.

Sincerely,

______________________________ (name, title, phone, email)

Attached: a copy of each invoice listed.

Part 4: Letter 2, the second notice

Send about 15 days after Letter 1. Delete any paragraph your agreement does not support.

[Your letterhead]

Date: ______________

To: ______________________________ (billing contact, title, and the facility or payer)

Account number: ______________

Subject: Second notice, $______________ past due on account ______________

Dear ______________:

We wrote to you on ______________ about the invoices below, and we have not received payment or a reply. As of today, the oldest invoice is ______ days past due.

Invoice number	Rides from and through	Amount	Due date	Late charge

Invoices: $______________ plus late charges: $. New total: $.

[Delete this paragraph if your signed agreement sets no late charge.] Section ______ of our [facility transportation agreement signed ______________ / service agreement signed ______________] sets a late payment charge of ______________. We added the charge shown above to the invoices that missed their due date.

Please pay the new total by ______________. If you cannot pay all of it by then, call ______________ at ______________ by ______________ and we will agree on payment dates in writing. A payment plan starts only after both of us sign it.

If you question any charge, tell us the ride date and the reason by ______________. We will correct any mistake and ask you to pay the rest on time.

[Delete this paragraph if your agreement does not let you pause bookings.] Under section ______ of our agreement, we may stop accepting new bookings while an invoice is past due and the time to fix it has ended. We would rather not. Rides already booked will keep running while we work this out.

Sincerely,

______________________________ (name, title, phone, email)

Attached: a copy of each invoice listed, and a copy of Letter 1.

Part 5: Letter 3, the final notice

Send only when you will take the step it names. Delete the step you will not take.

[Your letterhead]

Date: ______________

To: ______________________________ (billing contact, title, and the facility or payer)

Account number: ______________

Subject: Final notice, $______________ past due on account ______________

Dear ______________:

We wrote to you on ______________ and , and we called on , about the invoices attached. The total owed is $, made up of $ in invoices and $______________ in late charges the agreement allows.

Please pay $______________ in full by ______________ [by check to ______________ / by card at ______________ / by bank transfer to the account on file].

[Pause rides.] If we have not received payment by that date, we will stop accepting new bookings for [the facility / the rider] starting ______________, under section ______ of our agreement. Rides already booked through ______________ will still run, so you have time to arrange another provider for any rider with standing trips.

[Small claims.] If we have not received payment by that date, we will file a claim against ______________________________ in ______________________________ (court and county) to collect the amount owed, the late charges and interest the agreement allows, and court costs.

If you believe any amount is wrong, call ______________ at ______________ before that date with the ride date and the reason. We will correct any mistake.

Sincerely,

______________________________ (name, title, phone, email)

Sent by: ______________ (mail with tracking, email, or hand delivery) on ______________.

Attached: a copy of each invoice listed, Letters 1 and 2, and the agreement pages named above.

Part 6: Contact log

Write down ride dates, invoice numbers, and amounts. Leave out diagnoses and the reasons for visits.

Date and time	Letter or call	Who you reached (name and role)	What was sent or said	Promise: amount and date	Proof and next step

Who these letters can go to

Send them to a facility that signed an agreement to pay, and to a rider or a family member who agreed to pay. Do not send them to a Medicaid member for a ride Medicaid covers. Federal rule 42 CFR 447.15 limits Medicaid to providers who accept the agency’s payment, plus any copay the state plan requires, as payment in full. Whether a copay applies to rides depends on the state, and NEMT collections covers it, along with Medicaid coverage that reaches back to the ride date.

Two other payers need a different letter:

• Brokers and health plans. Use the claim appeal letter template for a denied trip, and late broker payments for one that is only slow.
• Counties, school districts, and federal facilities. They pay on a clock set by a prompt payment law, and the clock starts only when they receive a proper invoice. Before Letter 1, check that the invoice met the contract’s rules, then claim any interest. Local government prompt payment acts has the deadlines.

Which collection laws reach your letters

The federal Fair Debt Collection Practices Act and its rule, Regulation F, cover consumer debts, which are obligations of a consumer arising from a transaction primarily for personal, family, or household purposes (12 CFR 1006.2). A facility’s invoice is not one. A rider’s bill is, but the rule’s definition of a debt collector leaves out a creditor’s own officers and employees collecting in the creditor’s name, and includes a creditor that collects under any other name suggesting a third person is involved. Sign every letter with your company’s name and a real person’s name, and never invent a collections department.

California, Florida, and Texas have state laws that reach a business collecting its own consumer bills, and NEMT collections explains who each one covers. Other states have their own collection laws, so check yours before you write to a family. In those three states, the laws shape what the letters say:

• Name only a step you will take and may take. The federal law bars threatening an action that cannot legally be taken or is not intended (15 U.S.C. 1692e(5)), and California applies it to a business collecting its own consumer bills (Civil Code 1788.2 and 1788.17). Texas lets a collector threaten a lawsuit but bars threatening an action the law prohibits (Finance Code 392.301(a)(8) and (b)(2)). Florida bars asserting a legal right you know does not exist (559.72(9)). That is why Letter 3 tells you to delete the step you will not take.
• Do not dress a letter up as official. Florida bars a communication that simulates legal or judicial process, or looks as if a government agency or an attorney issued it when none did (559.72(10)). Use your letterhead, with no court-style caption.
• Keep the envelope plain. Florida bars words on an envelope or postcard calculated to embarrass the debtor (559.72(16)).
• Write to the lawyer when there is one. Florida bars contacting a debtor you know is represented by an attorney on the debt, with narrow exceptions (559.72(18)).
• Stay away from the employer. Florida bars contacting a debtor’s employer before a final judgment without written permission (559.72(4)).
• Call at sensible hours. Florida bars contact between 9 p.m. and 8 a.m. in the debtor’s time zone without consent, and email is excepted (559.72(17)). Regulation F treats a time before 8 a.m. or after 9 p.m. at the consumer’s location as inconvenient for a collector’s contact (12 CFR 1006.6(b)(1)).

What a letter may say about the ride

If your company is a HIPAA covered entity, which HIPAA for NEMT providers explains, collecting a bill counts as payment (45 CFR 164.501), and you may use a rider’s information for your own payment activities (164.506(c)(1)). Three rules then shape the letters:

1. Minimum necessary. When you disclose information for payment, make reasonable efforts to limit it to what the purpose needs (164.502(b)). The rule does not apply to what you send the rider (164.502(b)(2)(ii)), but it does apply to a facility or a family payer. So each letter lists invoice numbers, ride dates, and amounts, and never the diagnosis, the clinic type, or the reason for the visit. See minimum necessary.
2. Family payers see only their part. You may tell a family member only the information directly relevant to their involvement in the rider’s payment (164.510(b)(1)(i)). When the rider is present and able to decide, you need the rider’s agreement, a chance to object that goes unused, or a reasonable inference that the rider does not object (164.510(b)(2)).
3. Send letters where the rider asks. A covered health care provider must accommodate reasonable requests to receive communications at another address or by another means, and may not ask why (164.522(b)).

Collecting a ride fee does not call for a diagnosis. If a collection agency will handle the account, NEMT collections covers the business associate agreement.

Late fees and interest in Letter 2

Charge only what the signed agreement says, and quote its section number, because a fee the agreement does not name is one the customer never agreed to. The NEMT invoice template prints the same rule on every invoice. For the interest each state fills in when the agreement is silent, see the interest section of NEMT collections.

California adds a test for the fee itself, because its courts have judged late charges under Civil Code 1671. That section tests an agreed amount for a breach differently by customer. For a retail purchase of services mainly for the customer’s personal, family, or household use, subdivision (d) voids the clause unless it would be impracticable or extremely difficult to fix the actual damage. For other customers, such as a facility, subdivision (b) upholds the clause unless the customer shows it was unreasonable when the contract was made. A flat late fee on a family’s invoice is the one to show a California lawyer before you charge it.

A payment plan in Letter 2 can fall under credit law. Regulation Z defines credit as the right to defer payment of a debt. It treats you as a creditor only if you regularly extend consumer credit, meaning more than 25 times in the preceding calendar year (or in the current year, if you did not reach that count last year), on terms that carry a finance charge or are payable by written agreement in more than four installments (12 CFR 1026.2(a)(14) and (17)). A few plans a year are outside it. If plans become routine, ask your lawyer before you write more.

The final notice, a demand, and small claims

Letter 3 does three jobs: it gives the date, it names the next step, and it is the demand a court may ask about.

• The date comes from the agreement. Use its days to fix a missed payment, so the letter is also the notice to cure the agreement asks for. A stop date earlier than that period could put you in breach of the agreement. The facility transportation agreement leaves a blank for it in Part 14.
• Protect riders already on your schedule. Keep booked rides running until the stop date. A dialysis rider with standing trips needs those days, and so does the facility that must find another provider.
• California. The small claims form asks whether the plaintiff, where possible, demanded payment (Code of Civil Procedure 116.320(b)). Keep Letter 3 and its proof of delivery.
• Texas. To recover attorney’s fees on a services or contract claim, the claimant must be represented by an attorney, must present the claim to the other side, and payment of the just amount must not have been tendered before the 30th day after presentment (Civil Practice and Remedies Code 38.001(b) and 38.002). If you may hire a lawyer, make the deadline at least 30 days out and have the lawyer word the letter.
• The limit. Your claim must fit the court’s cap. The table in NEMT collections lists the small claims limits for a company in California, Florida, Ohio, and Texas, and who may appear for you.
• Proof of delivery. USPS’s price list effective October 4, 2026 charges $5.55 for Certified Mail on top of postage, plus $4.65 for a paper return receipt or $2.91 for an electronic one.

When the balance is too small or the customer too far gone for a lawsuit to pay, the accounts receivable guide explains writing it off on purpose. For card payments that avoid most of this, see NEMT credit card payments.