Assisting with Your Behavioral Health Collections
Providers are losing large amounts of revenue, when the insurance company sends their check directly to the patient instead of sending it to the provider. Providers become understandably confused about how this could happen considering that the providers billing and admissions staff had the patient execute all the correct authorizations, and a verified assignment of benefit (AOB) at the time of admission. Most providers think that if all such documentation is executed by the patient that regardless of whether they are in network or out of network the insurance reimbursement checks will be sent to their office. For many providers the assignment from the patient is unlikely to be honored by the carrier and its check will be sent to the patient anyway. This comes as a surprise to many providers who expect to receive the check from the carrier so long as it has a valid attested assignment of benefits.
In many cases both the patient and the provider’s staff are unaware that the insurance checks will be sent directly to the patient, even when the patient had already given the provider an assignment of benefits. And, even when the staff has informed the carrier of mistakes and oversights that are often made. Sometimes, it is only during a routine claim A/R review that the billing staff realizes that the check they have been waiting for has already been sent to the patient. The carrier generally does not routinely inform the providers billing staff of this circumstance.
This is when the problem becomes acute and financially damages the providers anticipated cash flow because it is extremely difficult for the provider to recover such insurance payments from the patient who has already received the check and potentially has cashed it. Obviously, the practice of issuing checks directly to patients instead of to the provider has greatly impacted the cash flow of many providers. Providers in Florida should make sure that the insured also executes an AOB and attests to it.
