A practice may decide to extend credit to patients through a payment plan that lets patients pay bills over time, rather than in a single payment. The Federal Trade Commission (FTC) enforces the Equal Credit Opportunity Act (ECOA), which prohibits credit discrimination on the basis of race, color, religion, national origin, sex, marital status, age, or because a person receives public assistance. If the practices decides not to extend credit to a particular patient, while extending it to others, under the ECOA the patient has a right to know why. Factors like income, expenses, debts, and credit history are among the considerations lenders use to determine creditworthiness. The practice must be specific in answering such questions.
Both the patient and the practice must agree to all the terms before the arrangement is finalized. Patients agree to make set monthly payments; if no finance charges are applied to the account, the arrangement is not regulated by law. However, if the practice applies finance charges or late fees, or if payments are scheduled for more than four installations, the payment plan is governed by the Truth in Lending Act, which is part of the Consumer Credit Protection Act. Patients must sign off on the terms on a truth-in-lending form that the practice negotiates with the patient.