# Before Referring a Therapy Patient Balance to Collections: What to Verify

A cautious operational checklist for validating a balance and reviewing notices, disputes, and policy before any outside referral.

## Confirm the balance before escalation

An unpaid balance is not automatically ready for outside collection. Before referral, make sure the underlying claim and patient account are complete, the amount is supported, and the practice has followed its own documented process. This is an operational checklist, not legal advice; collection laws and obligations depend on the circumstances and jurisdiction.

## A verification sequence

1. **Resolve insurance activity.** Check for pending claims, corrections, appeals, secondary coverage, or unposted remittances that could change the balance.
2. **Reconcile the account.** Apply payments and adjustments, review prior statements and payment arrangements, and confirm the amount is not duplicated or misallocated.
3. **Review communication and disputes.** Check that required notices were sent using approved channels, and that any patient question or dispute was routed and resolved according to policy.
4. **Confirm authority and process.** Verify the practice’s referral criteria, approvals, documentation, agency agreement, and applicable legal obligations with qualified counsel.
5. **Transfer only necessary information.** Use approved secure channels and share only information needed for the authorized purpose.

If any item is unclear, place the account on hold and assign an owner. Do not use a collection referral to resolve an unresolved insurance or posting issue.

## Make the escalation policy consistent

Written criteria help staff treat similar accounts consistently. Define review stages, exceptions, who approves a referral, how disputes are handled, and how a recalled or corrected balance is communicated. Revisit the policy when laws, payer workflows, or agency arrangements change.

## How Brace Health fits

Brace Health provides outsourced billing and RCM support to therapy practices, including billing follow-up and workflow coordination. The practice sets and approves its collection and patient-financial policies and remains responsible for deciding whether to refer an account. Brace does not provide legal advice or guarantee that an account is eligible for referral.