Author Topic: claims pay-to address to provider?  (Read 1359 times)

peluitz

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claims pay-to address to provider?
« on: February 02, 2011, 04:02:46 PM »
hi there. thank you so much for this forum. i really appreciate all the posts and info that can be found here, it's like a billing school of its own. i'm a newbie and just started a small billing office, so hopefully this question will not come off too dumb.

Q: Is it wise to make a provider's pay-to address under his own? which means he gets all the checks from his payors? is that a normal situation? or will that be bad for business since i will not have a way to find out how much he's been paid, especially if my fees are based on percentage? i was thinking this would be beneficial to the provider so there wont be a long wait to make changes with enrollment (esp. with medicare) to prevent delayed payments from his part.
please shed some light re this. thank you in advance.

PMRNC

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Re: claims pay-to address to provider?
« Reply #1 on: February 02, 2011, 05:41:44 PM »
You cannot do this with Medicare, the payments/EOB's must go to him.   You can do this with a lockbox. I personally don't think this is a good idea. As part of your contract you would put something in there such as " Provider is responsible for forwarding a copy of all checks, Payments, and EOB's to XYZ Billing Company" this should be in the provider responsibility section of your client.  Much safer and less margin for error.  When you are doing followup you can also work off your reports and then charge the provider for your time in chasing down these payments.  I do this and tricky part is you have to do it consistently in order to teach them, after it goes on for a while I try to address the issue with the provider and show them how much they are losing this way, if it still doesn't help, then I will terminate them.  Make sure whatever your policy, if any, is stated in your contract.
Linda Walker
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Pay_My_Claims

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Re: claims pay-to address to provider?
« Reply #2 on: February 02, 2011, 05:53:56 PM »
hi there. thank you so much for this forum. i really appreciate all the posts and info that can be found here, it's like a billing school of its own. i'm a newbie and just started a small billing office, so hopefully this question will not come off too dumb.

Q: Is it wise to make a provider's pay-to address under his own? which means he gets all the checks from his payors? is that a normal situation? or will that be bad for business since i will not have a way to find out how much he's been paid, especially if my fees are based on percentage? i was thinking this would be beneficial to the provider so there wont be a long wait to make changes with enrollment (esp. with medicare) to prevent delayed payments from his part.
please shed some light re this. thank you in advance.

Are you billing out of his system or yours?? When I enroll a provider, I set them up for ERA's. Since I am doing the posting, I need the EOB's. One gimmic is to let them know, it saves them time & money on having to fax the EOB's to me. Plus since they are ERA I can auto post them, giving me time to follow up on any other payments not received.  You don't need the checks, just the ERA's
Some remits you have no choice but to sign up ERA, I know Aetna no longer does paper you have to obtain it off of Navinet or get them through your own system. NC medicaid is the same, We get our ERA online with them.


peluitz

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Re: claims pay-to address to provider?
« Reply #3 on: February 03, 2011, 02:01:30 PM »
thanks a lot for the quick responses. i'll look into this. have a nice day.