What to do when an insurer pays the patient rather than you...

Some health plans are trying to force providers to join their network by making it more and more difficult to operate as a non contracted (also refered to as a non-par) provider. One of their tactics is to pay the patient directly so that the provider has to recover the money from the patient. If you've ever had the pleasure of explaining to the patient why the money isn't theirs or collecting the money after the patient spent it, then you'll be relieved to know there is another way to get paid.

The patient must assign their benefits and acknowledge their assignment in writing. A copy of the assignment should be provided with the claim and referenced on the claim when possible.

For more information about your legal rights if the payer ignores the notification, please refer to the attached Memorandum written by a California attorney. You may have the right to pursue the payer for payment even if they have already paid the patient.