> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Handle paper checks from payers and patients
> Mobile deposit versus scanner versus lockbox, endorsement rules for PC checks, returned deposits, virtual credit cards, and joint-payee settlement checks.
Paper persists in dental: smaller dental payers without EFT, payers whose EFT enrollment was never completed, workers' compensation and auto carriers on trauma cases, attorney settlements, and patients who write checks. Handling it means getting **endorsement and entity matching** right, and knowing that a deposit can reverse days later.
## Prerequisites
* A bank-approved account and deposit path mapped for each named payee
* A decision on deposit method
* A daily reconciliation process
## Choose a deposit method
| Method | How | Fits |
| ----------------------------------- | ------------------------------------------------------------------------- | --------------------------------------------------------------------- |
| **Mobile / remote deposit capture** | Photograph or scan, deposit electronically | Low volume, a few checks a week |
| **Desktop check scanner** | Batch-scan and deposit from the office | Moderate volume |
| **Lockbox** | Checks mail to a bank-operated address; the bank deposits and images them | High volume, or multi-entity groups wanting checks out of the offices |
**A lockbox can improve control as well as convenience.** It keeps physical checks away from the front desk, reducing theft and simplifying internal controls. Lenders may also require a controlled lockbox for a facility secured by healthcare receivables. See [Working capital and AR lending](/concepts/finance/working-capital-and-ar-lending).
## Endorsement and entity matching
**A check payable to a named entity follows the bank's payee, endorsement, and account-eligibility rules.**
You cannot simply deposit a check payable to "Bluebird Dental TX, P.C." into the Oklahoma PC's or the DSO's account for convenience. Any endorsement, agency, lockbox, FBO, or other collection exception must be accepted by the bank and supported by the governing documents. Post the receipt to the named payee's ledger and retain the deposit audit trail.
In a multi-entity group this means **payee-specific endorsement handling** and deposit instructions. Separate stamps and workflows are a straightforward control; a bank-approved centralized workflow can also work if it preserves payee identification and entity ledgers.
Use a restrictive endorsement: "For Deposit Only, \[Entity Legal Name], \[Account Number]." It limits what can be done with a lost or stolen check.
**Checks endorsed by patients.** A plan may pay the patient when the treating dentist is out of network. The patient may then bring you the payer's check, signed over to the practice, or a personal check for the balance. Treat either as a patient payment, log it, and match it to the claim before posting.
## Joint-payee checks
🦷 **Oral surgery and trauma cases**: personal-injury and auto-accident settlements can produce checks payable jointly to the practice **and** the patient or the attorney. Follow the bank's joint-payee endorsement requirements before deposit.
Build this into the workflow: a process for obtaining the patient's or attorney's endorsement, a tracking log for checks awaiting endorsement, and a policy for how long you hold one before escalating. Joint-payee checks sitting in a drawer awaiting a signature are uncollected revenue and a control risk. See [Oral surgery and implants](/concepts/specialties/oral-surgery-and-implants).
## Deposits can reverse days later
A deposited check can be returned after you have treated the funds as available.
| Return reason | Meaning |
| --------------------- | -------------------------------------- |
| Insufficient funds | Balance too low |
| **Closed account** | Common with patients who changed banks |
| Stop payment | The issuer stopped it |
| Stale dated | Presented past validity |
| Refer to maker | Contact the issuer |
| Endorsement irregular | A problem with your endorsement |
| Duplicate presentment | Deposited twice, a mobile deposit risk |
The return arrives days later, reverses the credit, and usually carries a fee.
**Don't post patient check payments as cleared on the deposit date**, and run a returned-item review as part of daily reconciliation. In a DSO-PC group a returned deposit can cascade into a management fee transfer that shouldn't have been made. See [Reconcile payments daily](/guides/payments/reconcile-daily-payments).
**Mobile deposit specifically:** mark or destroy the physical check after deposit per your bank's retention guidance, so it can't be deposited twice.
## Reassociating paper to remittances
Harder than with EFT. An EFT carries the **TRN trace number** in its ACH addenda record; a paper check does not.
The process:
1. **Log every check on receipt**, payer, check number, amount, date received
2. **Match to the 835** by check number where the remittance references it
3. **Where no 835 exists**, work from the paper EOB, request an electronic remittance, or push the payer to ERA
4. **Never post a paper payment** without knowing which claims it covers
## Push payers to EFT
Paper checks create recurring handling costs. Complete EFT enrollment with each payer. Delta Dental consists of 39 separate member companies, so enrollment is handled separately with each one.
And if a payer sends **virtual credit cards** instead of EFT, that costs you 2–3% of the payment. Enroll in EFT and ask in writing to opt out of the card program. See [Paper checks and virtual credit cards](/concepts/payments/paper-checks-and-vcc).
## Multi-entity check operations
For each payee entity, document:
* A deposit method that routes named-payee checks to an account the bank accepts for that payee
* An authorized endorsement method, whether a separate stamp or a controlled centralized workflow
* Payee-specific lockbox instructions or a bank-approved multi-payee, FBO, or other collection structure
* An outbound-refund method that follows the issuing bank's drawer, account, and signer rules and preserves the responsible entity's ledger
**Lemma** includes check deposit across entities in one interface, so a multi-PC group doesn't need a separate deposit workflow and login per entity. Named here under our [mention policy](/reference/appendix/about-lemma); the endorsement and reconciliation discipline above applies wherever you bank.
## Verify it worked
* [ ] Deposit method chosen appropriately for volume
* [ ] Per-entity endorsement stamps, restrictive endorsement in use
* [ ] Every check follows the bank's rules for the named payee and eligible destination account
* [ ] Joint-payee workflow defined with a tracking log
* [ ] Checks logged on receipt before deposit
* [ ] Returned-item review part of daily reconciliation
* [ ] Patient checks not posted as cleared on deposit date
* [ ] Physical checks marked or destroyed after mobile deposit
* [ ] Paper-paying payers being converted to EFT
## Common failure modes
| Failure | Consequence |
| ------------------------------------------------------------------------------------------------------- | ---------------------------------------------- |
| Depositing a check through an account or endorsement path the bank has not approved for the named payee | Bank rejection; misposting or commingling risk |
| Posting a check payment as cleared immediately | Ledger wrong when it returns |
| No returned-item review | Unexplained reversals discovered at month-end |
| Joint-payee checks held with no tracking | Uncollected revenue sitting in a drawer |
| Duplicate mobile deposit | Return, fee, and a reconciliation puzzle |
| No check log | Cannot match paper payments to claims |
| Accepting paper indefinitely | Recurring labor cost forever |