> ## Documentation Index
> Fetch the complete documentation index at: https://support.effra.io/llms.txt
> Use this file to discover all available pages before exploring further.
# Collecting patient shortfalls
When an insurer does not cover the full cost of treatment, the remaining amount is a shortfall that the patient owes your practice. Effra will automatically collect these payments on your behalf.
## Invoicing patients
If a shortfall becomes due, Effra will send the patient an invoice by email explaining the charge.
The invoice includes details of:
* The name of the practitioner
* The clinic location
* The date of treatment
* If applicable, the adjudication message from the insurer
Patients can then pay using a card or their preferred method, for example Apple Pay or Google Pay.
You can view the invoice that has been sent to a patient at any time by using these links on the invoice page of the Effra dashboard:
## Collecting patient payments outside Effra
If you collect payments for a patient outside of Effra, you simply need to mark the shortfall as paid, at which point we will cancel the invoice we've issued and no longer chase the patient for payment.
Simply click the add payment button on the invoice:
Please note, unlike insurer payments, external payments recorded in Effra are not automatically reflected in your PMS, so please make sure to add them there as well.
## Using a card on file
You can save a patient's card on file and it will be held securely using our payment processor Stripe. The patient enters their card details straight into a Stripe page where they are stored securely. They are never accessed by a member of your team or Effra.
If a shortfall becomes due, Effra will still send the patient an invoice by email and give them notice before any payment is processed. We will then collect the amount automatically on the due date. The due date is 5 days after the invoice is raised by default but this can be changed as preferred.
### Asking patients to add a card on file
You can ask patients to save their card details at any time, but the ideal opportunity is during patient registraion, before any shortfall arises.
**New patients** — Share the generic card on file link from the top right of the [patients page](https://app.effra.io/patients) in the Effra dashboard. Include this link in your registration forms, welcome emails, or other patient communications.
**Existing patients** — Share the patient-specific link from their page in the Effra dashboard when you need them to add or update their card.
You can also use [card on file reminder](/faqs/card-on-file-reminder) so Effra emails patients automatically when they have an insurance appointment but no card on file yet.
### Sample wording for patients
You can adapt the text below for your patient registration documents, welcome packs, or emails. Replace placeholders with your practice name and card on file link.
**Why do we need a payment method?**
If your health insurer does not cover the full cost of treatment (for example, if you have an excess on your policy), we need to collect the shortfall from you.
* You will receive an email invoice explaining any charges.
* We will give you notice before processing any payment.
* You can contact us directly at any time if you have questions.
* No payment will be taken today.
* We only store your card details securely with Stripe for future use.
Please add your card using this link: \[your card on file link]