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Escheatment is the process by which unclaimed property — uncashed refund checks, unclaimed payroll, aged credit balances — becomes the state’s rather than yours. Every state has an unclaimed property law, they apply to healthcare practices, and audits go back years. Unclaimed property law is state-specific, and the rules on dormancy periods, due diligence, and reporting vary. Confirm the requirements for each state where you operate. This guide describes the framework.

Prerequisites

  • An uncashed-check ledger, start it before you issue your first check
  • A credit balance process, see Resolve credit balances
  • Knowledge of which states you have property owners in

What counts as unclaimed property

An unrefunded patient credit balance is unclaimed property even if you never issued a check. Practices that leave credit balances on accounts indefinitely are accruing an unclaimed property liability, not avoiding one.

Which state gets it

Governed by longstanding priority rules derived from US Supreme Court decisions on interstate escheat:1
  1. The state of the owner’s last known address in your records
  2. If no address, or the address state has no applicable law, the holder’s state of incorporation
Practical consequences for an MSO-PC group:
  • Property is reported to the patient’s state, not necessarily yours
  • A multi-state group reports to multiple states
  • Address hygiene matters — a missing or wrong address changes which state gets the property, and defaults it to the entity’s state of incorporation
  • Each PC is a separate holder with its own reporting obligation

The pipeline

Steps

1

Keep the uncashed-check ledger from day one

This is the whole ballgame. Record every check: number, amount, payee, payee’s last known address, issue date, entity, and clear date.Reconstructing this in year three, across multiple entities, from bank statements, is exactly the work a state unclaimed property audit will make you do, and audits routinely look back a decade or more. Starting the ledger costs nothing; reconstructing it costs weeks.
2

Reconcile it monthly

Match issued checks against cleared items. Anything outstanding past the stale date printed on your check stock, commonly 90 to 180 days, moves to the due diligence queue.
3

Attempt re-contact before the stale date

Cheaper and better for everyone than escheatment. Call, email, or text. Verify the address. Reissue if they simply never received it.
4

Send the due diligence letter

Most states require a written attempt to contact the owner before reporting, within a specified window before the reporting deadline, and often with prescribed content.Send it to the last known address, retain a copy and proof of mailing, and record the date. States also frequently set a dollar threshold below which due diligence isn’t required.
5

Track the dormancy period

The dormancy period is the time the property must remain unclaimed before it must be reported. It varies by state and by property type — uncashed payroll frequently has a shorter period than other property.See Unclaimed property by state for the framework, and confirm against each state’s current statute.
6

Report and remit

Most states use a common reporting cycle with an annual deadline. Reports are filed electronically in a standard format, with the property remitted alongside.File per holder entity, per state. Each PC files its own.
7

Retain records after remitting

States typically require retention for a period after reporting, and an owner who later comes forward is directed to the state, but you may need to evidence what you reported.

Voluntary disclosure

If you discover you have years of unreported property, which is common when a group first looks, most states offer a voluntary disclosure agreement program: you come forward, report the backlog, and typically receive penalty and interest relief. Voluntary disclosure is materially better than being audited. Unclaimed property audits are frequently conducted by contingency-fee third-party auditors, look back many years, and use estimation where records are incomplete, which is why the ledger matters so much. If you have a backlog, take it to counsel and consider voluntary disclosure before an audit letter arrives.

Multi-entity considerations

This is one of the quieter ways multi-entity overhead compounds, and one of the more common findings in diligence.

Prevent it

The best escheatment process is a small one:
  1. Refund promptly. Weekly credit balance review, resolution within 30 days.
  2. Refund to the original payment method wherever possible — card refunds don’t go stale.
  3. Verify addresses before mailing a check.
  4. Follow up on uncashed checks at 30 and 60 days, before they go stale.
  5. Collect good contact information at registration and keep it current.

Verify it worked

  • Uncashed-check ledger maintained from the first check, per entity
  • Reconciled monthly
  • Re-contact attempted before the stale date
  • Due diligence letters sent per state requirements, with proof retained
  • Dormancy periods tracked per state per property type
  • Reports filed per holder entity, per state, by the deadline
  • Aged credit balances included, not just issued checks
  • Records retained after remitting
  • Backlog, if any, discussed with counsel regarding voluntary disclosure

Common failure modes

Sources

  1. Interstate priority rules derive from Texas v. New Jersey, 379 U.S. 674 (1965), and subsequent cases. State unclaimed property administrators are indexed by the National Association of Unclaimed Property Administrators at unclaimed.org.