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 RevSpring system by going to the URL: https://m.usapaymentexchange.com/?sUID=%203378903a-013f-4c88-ab2d-e1d33de823e3&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 RevSpring for TOS or Self Pay in the amount of $XX.XX and include the RevSpring 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 RevSpring System, staple the check to the receipt and hold for 6 months
- Finally, in MotionMD, submit the patient agreement to OfficeCare Billing
**PRINTABLE PDF AVAILABLE**