Insurance Payments to You

Why do medical insurance companies send you, the patient, the payments that should be going to the doctor? What are you supposed to do with these checks? is there a specific procedure that you are supposed to be following, that nobody every told you?

Here is what usually happens. You locate a doctor that you trust, and you have been going to them for awhile, and suddenly you start receiving insurance checks in the mail. You have no idea what is going on. Who do these checks belong to? Usually your insurance company will issue checks to you the patient, when the doctor is out of network, or doesn’t participate with your insurance plan. And, did you know that if there are several doctors in the group, that some can be participating and others can decide not to participate? So if you saw a doctor in that group who does not participate with your insurance, then you will receive the insurance check. So what are you supposed to do with this check?

I recommend that you cash the check. DO NOT HOLD ONTO IT! Make a copy of the check and then deposit it into your checking account.  Keep the copy of the check with your insurance explanation of benefit that came with the check. When you receive a bill from your doctor, send a personal check along with copies of the explanations of benefits and the copy of the check and send the exact dollar amount of that insurance check to the provider.  I do not recommend sending the check to the provider until they send you a statement so that your payments will be applied correctly to your account.

Do not make your doctor chase you down for that money as it was never yours to begin with. And do not pay the doctor less than the insurance paid you. You should NOT be making money off of your medical appointments.

Now suppose you receive a very large check, for thousands of dollars? Make copies of the entire document, including the check and then bring everything to your doctor’s office. Go to the billing department and endorse that check over to the practice. Have them give you a receipt for the check and keep that receipt stapled to your copies of the EOB and check. The sooner you bring your doctor the insurance checks, the happier they will be with you.