a crucial process in healthcare billing that involves recording and matching payments
received from insurance companies, patients, or other payers to ensure accurate payment for healthcare services. This task helps in maintaining financial records and complying with regulatory requirements.
- Receipt of Payment: Received from insurance companies, patients or other payers via checks, electronic funds transfer or credit card payments.
- Identification: Payment is matched to the corresponding claim or invoice.
- Verification: Payment amount is compared to the expected amount based on the contract between the healthcare provider and the payer.
- Application: Payment is applied to the appropriate account such as the patient’s or the healthcare provider’s revenue account.
- Reconciliation: Payment is reconciled with the corresponding claim or invoice, ensuring accurate recording and accounting.
- Denial or Underpayment: If payment received is less than expected or denied, the team investigates and takes appropriate action, such as filing an appeal or resubmitting the claim.
Payment posting
Electronic Remittance Advisory (ERA) Posting
Manual Payment Posting
Denial Posting
Posting Patient Payment
We process different types of remittance transactions with high accuracy and timeliness. These include Electronic Remittance Advisory (ERA) Posting, which typically involves a high volume of payment transactions, manual payment posting, denial posting, and posting patient payment.
Patient Payments
Patients can pay their co-pays, deductibles, or non-covered services using cash, check, or credit card.
Insurance Payments
Insurance payments are processed through an electronic system called Electronic Remittance Advice (ERA) to batch process payments and correct any issues. If ERA is not available, insurance payments are manually processed.
E0B Processing
Insurance payments made without ERA are manually processed. The balance is then transferred to the secondary insurer if applicable.
Denial Posting
Denied claims may be re-billed to secondary insurance, transferred to the patient, written off, or sent for reprocessing. This ensures that the claim is processed correctly and accurately.
Soft Denial: Temporary denial that can be reversed if the provider corrects the claim or provides additional information.
Hard Denial: Irreversible denial that often results in lost or written-off revenue.