Please follow the below instructions to process a check payment:
- Create a MotionMD patient agreement
- Have the patient write out the check payable to DJO
- Log into the Revenue Advantage system by going to the URL: https://m.usapaymentexchange.com/?sUID=e7bdccba-decf-40fd-aa52-7dbccef93418&aid
- After logging into site, add "=yourfirstnameandlastnameOC" to the end of the URL, this will tie the transaction to a specific user so any reporting can identify who completed the up front collection.
- Process the payment transaction. Once complete, print a receipt and attach to the PA
- In the note section of the patient agreement, please check the patient visible box and write the following:
- Processed check number XXXX through Revenue Advantage for TOS or Self Pay in the amount of $XX.XX and include the Revenue Advantage Confirmation #.
- Using the iPad camera, upload a receipt from the Revenue Advantage system to the patients MotionMD patient agreement
- After the process is completed on Revenue Advantage System, staple the check to the receipt and hold for 6 months
- Finally, in MotionMD, submit the patient agreement to Cognizant
**PRINTABLE PDF AVAILABLE**