Practice Management Alert

Question: My practice filed a claim with the benefits assigned to us. But, the insurance company sent the payment to the patient instead of to us. He cashed the check and refuses to pay. What can I do to collect the money?

Illinois Subscriber  
Answer: Sometimes, there is a contract between the insurance company and the patient, and the money will never come to the practice, regardless of the benefit assignment on file. In that case, its the patients responsibility to ensure you are paid. Inform the insurer that you have a benefit assignment on record and press him or her to persuade the patient to pay. Point out that the patient-insurer contract is violated when patients shirk their financial responsibility. By not helping you get paid, the company is assisting the patient in defrauding you of your services. You could also inform the patient that failure to pay violates the patients contract with the insurer, and the coverage could be lost. If the patient persists in refusing to pay, turn the claim over to your collection agency.