Medical Billing and Payment Posting Service – USA

The billing cycle is completed when both insurance and patient payments are received and posted correctly. Regardless of the general perception, payment posting is not data entry and it should not be done in a rote method. Posters need to have a good understanding of remark codes included on explanation of benefits (EOBs), fee schedule structure, and insurance rules and contracts. Incorrect payment posting can lead to loss of income for the practice. At FC Billing, we are in constant communication with insurance companies, providers, and patients to ensure highest level of accuracy of account management.

How important is accurate payment posting?

How important is accurate payment posting?

Payment posting is comparable to cash balancing for any business or banking. Inaccurate payment posting will show over-collection or under-collection, both will lead to account errors. It will also lead to inaccurate billing for patients, fee schedule errors, and confusion in future follow-up with insurance and patients. If insurance pays below the contracted rate, payment error needs to be identified immediately and an appeal needs to be submitted to reprocess the claim.

Our Payment Posting Process

During an initial meeting with a provider’s office, the manager told us that she just needs us to submit the bills, no posting was needed. Office would do their own posting because she said, “it’s easy, it’s just data entry”. Payment posting is an invaluable part of the billing cycle. It filters out billing and insurance claim processing errors.

For example, if an Ophthalmologist does procedure on both eyes and the claims lack proper modifiers, claims will be underpaid. The payment will actually be for one eye. If a dermatologist does biopsy on multiple sites and the claim fails to indicate this information with proper modifiers, diagnoses, and additional claim details, claim will be underpaid.

Our team examines each Explanation of Benefits (EOBs) for underpayments and over-payments, as both should be addressed immediately. We make sure payment for each claim has been made according to fee schedule, frequency, and units. We address all remark codes, non-pays, and inaccurate payments before finalizing EOBs. As we take the final step of posting payments into the software, providers can be certain that accurate payment has been received for each claim.

medical payment posting
what is payment posting in medical billing

FC Billing Can Alleviate the Burden of Payment Posting

We review EOBs for payment discrepancies, missing payments, and rejections. After posting is complete, either through electronic or manual method, we work on all issues noted on the EOBs.

Payment posting best practice :

  • Electronic EOBs (ERAs) – We review all EOBs in Clearinghouse and insurance portals for claim payment issues. Once checking is completed, we download EOBs into provider’s software. Once posted, we check each patient’s ledger and cross-check with EOBs to ensure correct posting.
  • EOBs with paper checks – We verify with the provider’s office if checks have been received and deposited. Once deposit is done, we enter the payments into the software and manually post all the payments. We also cross-check the posted amount with EOBs for a final review.
  • We review all insurance letters that come through mail, email, and portals and take all necessary actions for claim payment, compliance, coding updates, and billing changes.

After all of the above steps are completed, we follow-up on any issues we have highlighted. We work on each non-pay claim within 24 hours of receiving rejection. Our system is set up to catch any error quickly and ensure claim payment.

Why Choose FC Billing for Payment Posting

  • Accurate payment posting
  • Payment analysis
  • Experienced in electronic and manual posting
  • In-depth knowledge of claim follow-up
  • Fee schedule analysis
  • Claim submission to all insurances
  • Patient billing
  • Established liaison with insurances
payment posting service

Why Should You Outsource Your Payment Posting

It is not always possible for medical practices to hire several billers to tackle different parts of the billing cycle. By outsourcing your billing, you will be able to hire specialists who are well versed in all parts of the billing cycle. Our billers are highly trained to scan each EOB for remark codes, non-pays, and payments discrepancies. 

payment posting best practices

1. Review of EOBs for Correct Payments

Our team reviews each Explanation of Benefit (EOB) for accuracy. We ensure payment for each claim has been made according to the insurance contracted fees. We address all remark codes, non-pays, and payment errors before posting EOBs.

2. Fee schedule analysis

If we find payment discrepancies, we follow-up with insurance for reprocessing, appeals, medical record review, or any other needed adjustments.

3. Patient Billing

We send statements to patients for patients’ responsibilities. If patients do not pay within set time limit, we notify the doctor’s office of overdue balances to take further action. We also send monthly patient credit reports to the office so they can make any needed refunds.

4. Reports

We generate reports at the end of workday to cross-check all payment posting. We also take confirmation from doctors’ offices about paper check deposits before posting payments. We diligently follow up on any missing payments and have insurances re-issue any missing checks.

what is payment posting in rcm

FAQ

Once the Insurance companies receive claim/bill from provider’s office, they have their billing/processing department price the claim and if the claim passes their inspection (Clean Claim), insurance will then issue payments to providers. Once payment is received, providers’ offices will have to make sure of the correct payment amount and post it into the patient’s ledger. If there are any patient balances, statements will have to be sent to patients.

Revenue cycle management is the process of managing delivery of services to patients and ensuring payments for these services. Any work that has to be done to ensure efficiency of this process also falls under RCM.

All billing software has built-in features to transfer EOB payments from clearing house to the software and auto-post payments into patients’ accounts. This feature provides accurate posting and reduces payment posting time.

EOBs which come by mail or fax and have no copies uploaded to the clearing house by insurances, are referred to as paper EOBs. Paper EOBs cannot be auto-posted. Biller will have to post each payment individually into patient accounts. This is referred to as manual posting.