Claim Paid to Wrong Address - Medical Billing

What we can do if the claim paid to wrong address


Claims are created, filed with the insurance company, and the insurance company processes the claim, and pays on it as a clean claim. Where does this payment go? It should go to the correct pay-to-address of the provider, only then it serves the final purpose of Medical Billing.
Now, imagine what will happen if the insurance company has a wrong pay-to-address for the provider. All the checks will be wrongly directed to an address, which does not belong to the provider, and gets accumulated there. This is not a big problem if identified earlier else if it is being plotted after quite a period of time, it becomes a great disaster.


Usually in these cases, the insurance company representative confirms the Doctor’s address with the person, who calls up the insurance company, and if it is the same address, which she has in her system, and if the check would

have been sent to the wrong address, she will put a stop-payment on the previously issued check, and generates a new check to be mailed out to the Doctor’s correct pay-to-address.

If the address, which she has in her system for that particular provider is not the same as it has been told by the Doctor’s office, she asks the concerned person from the Doctor’s office to fill up a W9 form (a form which is used by the insurance companies to update the Physician’s information) in which the correct pay-to-address of the Provider should be mentioned, and send it back to the insurance company. The insurance company reviews the form and updates the Doctor’s pay-to-address in their system accordingly.

Now-a-days these problems do not arise often as the insurance companies have started paying the Doctors through
EFT[Electronic Fund Transfer]. They have a Payer ID for every provider, and dispatch the payment through this mode of EFT. Thanks to the Electronic revolution!!!

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