What to expect, 6 of 7Read this when an insurer sends you something and you are not sure what to do with it.
Checks, cards, and letters from insurers.
Direct deposit and ERA setup, what still arrives by mail for a while, and the rule for all of it: forward it to us.
Once you are in network, insurers write to your practice: checks, explanation-of-benefits statements, virtual debit cards, directory attestation requests, re-credentialing notices, contract amendments, and records requests. The rule for all of it is the same. Deposit paper checks, leave virtual cards alone, and forward us a photo or scan of every page, including the check number. We post payments and tell you what, if anything, needs a decision from you.
Direct deposit and ERAs
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We enroll every payer once you are approved
EFT (direct deposit) and ERA (electronic remittance) are separate enrollments per payer, and one can be active before the other. We file both as each approval comes in; if we do not have your voided check or bank letter yet, we ask for it then.
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Some payers go through a middleman
Optum, Availity, Zelis, ECHO, and PaySpan handle deposits for many plans. Some of these need the authorized signer (you) to approve a request or enter a code. We tell you when.
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Expect a few weeks of overlap
BCBS is often about 15 business days; some take longer. Until an enrollment is active, checks or virtual cards may still arrive from that payer. The Monday email shows each enrollment as requested, pending, or active.
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Say no to virtual cards
Some payers default to a debit card that charges a processing fee. Do not activate it. Forward it and we will switch that payer to a no-fee deposit, even if it means paper checks briefly.
What arrives and what to do
A check with an EOB
Do this: Deposit it. Forward the EOB and the check number. Do not enter it in the EHR yourself.
Then we: Post it against each client and date of service once, and move that payer to direct deposit.
A virtual debit card
Do this: Do not activate it. Forward it.
Then we: Have the payer re-issue and opt you out.
An EOB with no check (or a $0 EOB)
Do this: Forward it.
Then we: Check whether it was paid electronically, applied to the deductible, denied, or adjusted, and act on it.
A directory or attestation letter ("confirm your information")
Do this: Forward it.
Then we: Complete it. These come every few months and lapsing one can suspend you from the directory.
A re-credentialing notice
Do this: Forward it.
Then we: Ask you, then handle it ($50 per payer per clinician). Commercial payers about every three years; Medicare every five.
A contract, amendment, or fee schedule
Do this: Forward it the day it arrives, before signing.
Then we: Flag the rate, anything that changed, and the deadline, so you can decide and sign in time.
A records request or audit
Do this: Forward it the day it arrives.
Then we: Tell you the deadline and exactly what to send. You send the records (progress notes and treatment plan, not separately kept psychotherapy notes); we do not access them.
A refund request (overpayment)
Do this: Forward it; do not pay it yet.
Then we: Verify it against the ERA. Payers are sometimes wrong, and some can be offset instead of refunded.
One address for all of it
Forward to the same billing address you added to your EHR, or reply to any Monday email with the photo attached. A clear phone picture of every page is fine; include the check or trace number.