April 1, 2014



My patients are keeping insurance checks.  What do I do now?  My office has sent numerous letters but we are not being sent or delivered the checks. 

Please advise.  Thanks.  
Dr. S


A patient keeping a check meant for your practice, where you have agreed to accept assignment of benefit or where the check was accidentally sent to the patient as opposed to your practice address is insurance fraud.  And, practically speaking, the patient is literally stealing from your practice.  Many patients do keep checks (sometimes with the intent to defraud), and spend the money as soon as received, making recovery more difficult.  Our office often hears as an excuse, "the money is gone, I spent it."  

Many of our clients are against suing patients, which I can understand.  But, I cannot understand not taking a more stringent approach against a patient perpetrating insurance fraud and stealing from your practice.  What strikes me as most offensive, is some patients will steal insurance checks out of your pocket and continue expecting care as a patient of the practice.  

My recommendation - if you have identified instances where patients have kept insurance checks - 

1.   Notify the department of finance by filing a complaint - http://www.dfs.ny.gov/consumer/fileacomplaint.htm - you are filing a complaint not only against the individual but potentially against the insurer failing to abide by your legal assignment of benefits form (Not sure you have a proper form?  Contact our office for review).

2.  Review your in-office policies to ensure you have a clear financial policy explaining to patients they are responsible for turning over checks received, and responsible for paying any co-payments required. 

3.  Take an active role in your collection process - do not be afraid to pursue debts owed to the practice.  Work with your biller to send at least 3 bills out to patients and if that doesn't work, 

4.  Have our office start a collection action against the patient.  The collection process can be as simple as a legal letter directing payment to YOUR office (which we do for a flat fee of $50) or it can involve starting a law suit which is handled on contingency.  Regardless of the path you choose, do not let patients steal from you.  Enforce your right to collect.  

Call Jennifer with questions on collection or visit our website HERE for more information.