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. Payment 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 FCbilling, 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?
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 to 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 insurance to reprocess claim.
Our Payment Posting Process
Once, during an initial discussion 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 a procedure on both eyes and the claim lacks proper modifiers, claim 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, diagnosis, 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 posting 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.
FCbilling Can Alleviate Your Burden of Payment Posting
- We scan EOBs for any payment discrepancies, missing payments, and rejections. After posting payments, either through electronic or manual posting, we work on all issues highlighted on the EOBs.
Payment posting best practice :
- Electronic EOBs (ERAs) – We review EOBs in Clearinghouse and insurance portals for any issues. Once checking completed, we then download EOBs into provider’s software. Once posted, we check each patient’s ledger and cross-check with EOBs to ensure correct posting.
- Paper EOBs and EOBs with paper checks – We verify with the provider’s office if checks have been deposited into the bank. 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 the EOBs for a final review.
- We review all insurance letters that come through mail, email, and portals and take all actions necessary for claim payment, compliance, coding updates, and billing changes.
After all of the above steps are completed, we go back to the EOBs and 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 FCbilling for Payment Posting
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 inaccurate payments.
Our payment posting service includes:
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.