Patient Check Deposits: How to Ensure Every Check Reaches the Bank

Patient checks are becoming rarer, but when you receive them, they represent real money that must reach the bank. One lost check can mean hundreds of dollars gone.

Why Check Handling Still Matters

Even as electronic payments dominate, dental practices still receive patient checks. Insurance companies sometimes mail check payments. Patients of certain demographics prefer checks. Flexible spending and health savings accounts may issue checks.

Each check represents money you have earned. Poor check handling means:

• Lost revenue from misplaced checks
• Theft opportunity from weak controls
• Reconciliation problems from inconsistent processes
• Patient disputes from posting errors

Good check handling is increasingly rare as a skill, making it even more important to have clear procedures.

The Check Handling Lifecycle

Receipt

When a check arrives:

In person at checkout:

• Verify check is complete (date, amount, signature)
• Verify amount matches patient balance or agreed payment
• Note check number for records

By mail:

• Log receipt immediately
• Note date received
• Verify intended for your practice

Recording

Enter the payment in your system:

Immediately:

• Post to patient account
• Record check number
• Record check amount
• Select correct payment type

Why immediately: Delayed recording increases risk of loss and makes reconciliation harder.

Endorsement

Prepare the check for deposit:

Best practice:

• Endorse immediately upon receipt
• Use "For Deposit Only" stamp with account number
• Restrictive endorsement prevents negotiation if stolen

Stamp format:

For Deposit Only
[Practice Name]
[Account Number]

Storage

Secure checks until deposit:

Requirements:

• Locked location
• Limited access
• Daily or frequent deposit to minimize inventory
• Log of checks awaiting deposit

Deposit

Get checks to the bank:

Options:

• Physical deposit at bank
• Remote deposit capture (mobile/scanner)
• Night deposit for after-hours

Timing: Daily deposits minimize risk.

Verification

Confirm deposits clear:

Process:

• Verify deposit appears in bank account
• Confirm amount matches deposit slip
• Watch for returned checks

Check Handling Procedures

Standard Procedure

Implement consistent steps:

Step 1: Receive and verify

• Examine check for completeness
• Verify payee is your practice
• Confirm amount

Step 2: Record immediately

• Post to patient account
• Enter check number
• Document payment

Step 3: Endorse

• Apply restrictive endorsement stamp
• Do this before setting check down

Step 4: Secure

• Place in designated secure location
• Log on check tracking sheet
• Do not mix with other documents

Step 5: Prepare deposit

• Complete deposit slip with check numbers
• Verify total matches sum of checks
• Copy or image checks if required

Step 6: Make deposit

• Deposit same day or next business day
• Obtain deposit receipt
• File receipt with documentation

Step 7: Verify

• Confirm deposit posts to bank
• Match to deposit slip amount
• Investigate any discrepancies

Check Log

Maintain a log of checks received.

Log contents:

• Date received
• Patient name
• Check number
• Amount
• Date posted to PMS
• Date deposited
• Deposit reference

Purpose:

• Track checks from receipt to deposit
• Identify any missing checks
• Support reconciliation
• Audit trail

End of Day Check Count

Verify checks before deposit.

Process:

1. List all checks received today
2. Verify each is endorsed
3. Verify each is in PMS
4. Prepare deposit slip
5. Compare check count to log

If discrepancy: Investigate immediately before depositing.

Remote Deposit Capture

Many practices use mobile or scanner deposit.

Benefits

Convenience:

• Deposit from office
• No bank trip required
• After-hours capability

Speed:

• Faster funds availability
• Same-day cutoff possible
• Immediate confirmation

Documentation:

• Automatic images
• Digital records
• Easy retrieval

Best Practices

Scanning:

• Clear, complete images
• Both sides of check
• Verify image quality before submitting

After scanning:

• Mark check as deposited (stamp or notation)
• Store securely per bank policy
• Destroy per bank guidelines (typically after confirmation)

Reconciliation:

• Verify scanned deposits post to bank
• Match deposit confirmations to check log
• Investigate rejections immediately

Common Issues

Image quality:

• Ensure good lighting
• Clean scanner
• Check not folded or damaged

Duplicate deposits:

• Never deposit same check twice
• Mark checks clearly after scanning
• Verify before scanning if unsure

Check Theft and Fraud Prevention

Internal Theft Risks

Employees may steal checks if controls are weak.

Theft methods:

• Taking check before recording
• Altering check and depositing elsewhere
• Forging endorsement
• Recording check then removing

Prevention:

• Immediate endorsement
• Segregation of duties
• Regular reconciliation
• Surprise audits

External Fraud Risks

Patients may provide bad checks.

Fraud methods:

• Insufficient funds (NSF)
• Closed account
• Stolen checks
• Forged checks

Prevention:

• Check verification services
• Collect ID for large checks
• Know your patients
• Follow up on returned checks

Control Recommendations

Segregation:

• Different people receive, record, and deposit
• If not possible, implement compensating controls

Verification:

• Someone other than handler verifies deposit
• Match bank deposits to PMS weekly
• Review check log regularly

Documentation:

• Images or copies of all checks
• Complete check log
• Deposit receipts retained

Returned Checks

Checks that bounce require action.

When a Check Returns

Bank notification:

• Bank debits your account
• Provides reason code
• Returns check (physical or image)

Common reasons:

• NSF (insufficient funds)
• Account closed
• Stop payment
• Signature issue

Response Process

Step 1: Adjust patient account

• Reverse the payment in PMS
• Patient now owes original amount plus any fee

Step 2: Contact patient

• Notify of returned check
• Request replacement payment
• Apply returned check fee if your policy allows

Step 3: Document

• Note in patient record
• Update check log
• Track collection efforts

Step 4: Consider policy

• May decline future checks from this patient
• Collection if unresolved
• Small claims court for significant amounts

Prevention

Before accepting:

• Check verification service for new patients or large amounts
• Confirm ID matches check

Policy:

• Return check fee disclosed
• Written policy provided
• Consistent enforcement

Reconciliation for Checks

Daily

• Verify checks received match checks deposited
• Check log complete
• All checks posted to PMS

Weekly

• Match bank check deposits to PMS check payments
• Investigate any discrepancies
• Review check log for anything outstanding

Monthly

• Sum month's check deposits from bank
• Sum month's check payments from PMS
• Investigate variance
• Clear or document any outstanding items

Special Situations

Insurance Checks

Insurance checks need additional handling.

Differences:

• May cover multiple patients
• ERA/EOB provides allocation
• Often larger amounts

Process:

• Match check to ERA/EOB
• Post per claim breakdown
• Verify total posted equals check
• Deposit with patient checks

HSA/FSA Checks

Health account checks have quirks.

Considerations:

• Often third-party issued
• May have unique formatting
• Verify payee is correct

Post-Dated Checks

Checks dated in the future.

Policy options:

• Decline and request current-dated check
• Hold and deposit on stated date
• Note clearly to prevent premature deposit

Risk: Depositing early may result in return.

Third-Party Checks

Checks from someone other than patient.

Considerations:

• Verify proper endorsement
• May require both payee and depositor endorsement
• Higher risk of issues

Want to ensure every check reaches the bank and reconciles properly? Zeldent tracks all payments including checks, matching your PMS records to actual bank deposits and flagging any discrepancies. Stop wondering if something slipped through. Schedule a demo to see complete payment reconciliation.