www.njchiropractors.com I 15 on paper with a copy of your AOB. Make sure to stamp/write on the top of your CMS-1500 forms “Assignment of Benefits Attached.” This way a payer can’t say they never received the assignment of benefits. By marking the top of each of your CMS-1500 forms, you are telling them to look for the AOB. You can send one copy of the AOB or attach several copies for the more difficult payer. Remember to send the AOB every time you bill to these payers. Just because they should have it on file does not mean they will have it on file, so always resend it with each billing. Regardless of all the steps you take with the payers, there will always be some checks that make it to the patients. You want to make sure you are ready for this if it happens. 1) Always be on top of your accounts receivable (especially if you know it is a company that sends checks to patients). From my experience, patients are less likely to cash your checks if they know you are on top of them. Give the patient a call immediately once you know they have received a check. 2) Once you have called the patient, immediately send them a letter with a pre-addressed stamped envelope. With your letter, I would attach the forms the patient signed regarding receiving checks just as a reminder. Of course, your office knows your patients, so use this step at your own discretion. 3) Make a follow-up call log. The everyday workload can make you forget if a patient brought a check to the office. Using a paper log can help. Most software has a note field where staff can leave communications, but I have found not everyone knows how to use these fields, such as new staff, doctors and associates. I have had several instances where patients give checks directly to doctors and the doctors forget to tell anyone about them. Make the log a rule. When you contact a patient for a check, write it down. Use the patient’s name, amount of checks, how many checks and date you contacted the patient. You should also have a spot to sign if the patient brings in the checks and an area to comment on additional calls made, if needed. The log should be kept where all staff and doctors can access it. If a patient brings in a check when the billing staff are gone for the day, the front desk can initial it in the log. The doctors should be required to do the same if they receive checks from the patient. You should review the log every two to three days and call back if needed. It has been my experience the longer the patient has a check, the less likely you are to recover it so be sure to diligently track these checks/ patients. 4) Stop treating patients that don’t bring in checks. I see a lot of doctors make this mistake. They continue to treat patients that do not bring in checks to their office. In some instances, the doctors are unaware of the issue due to poor communication within the office. They want to be the nice doctor, or the patient keeps promising to bring the checks, and they hope they are telling the truth. The problem with continuing to treat these types of patients is they are getting paid to go to the doctor, and your office is losing money every time your doctor treats them. Make sure to tell your doctor the situation, but don’t get him involved. This means get his input behind closed doors, but don’t make him discuss finances with the patients. There is a fine line between the clinical side of the practice and the business side of the practice. The doctor, in my opinion, should never be on the business side in the patients’ eyes. Communicate with other office staff so they know the situation, especially front desk staff since they are your gatekeepers. Give the patient options: “Mrs. Jones, once you bring in your checks that you received from the insurance companies we can get you scheduled for your next visit. If you feel that you cannot wait to schedule with us, we can recommend a few other doctors in the area that you can call and see if they have immediate openings available.” If the patient still doesn’t bring the checks at that point, then your office has to decide if that is a patient you want at your office moving forward. 5) If you are unable to recover the checks, then you have to decide whether you want to send your patients to collections, ultimately ending with you suing the patients in court if they do not make a payment arrangement in the collections phase. This is not a step for all offices. You have to decide how aggressive your office wants to be. However, if you took the steps above, you should have the signed documents that will aid you in recovering your professional fees, attorney fee and any other fees associated in the collection of the outstanding fees. Furthermore, make sure the collections company/attorney you hire to handle the cases for you knows what they are doing so you are able to recoup all the professional fees due to you. Heather M. Garcia, CBCS, CMAA, CMB, has been in the medical billing and consulting business for over 17 years. She launched Smart Healthcare Solutions, Corp., in 2005, and it has offices nationwide. Garcia has been an expert witness in New York no- fault litigation trials and has also participated in the Medical Assistant/ Medical Coding and Billing Advisory Board for Lincoln Tech. Insurance Update Medicare Q&A