Medical payment posting involves posting (entering payments into billing software) and reconciling of money received from payers. It is a crucial process that has a huge impact on several other functions of a healthcare business such as revenues, overall efficiency of processes, and patient satisfaction. But the biggest benefit of payment posting is that it provides insight into the daily earnings of a practice and helps them spot potential issues and nip them in the bud. To sum it up payment posting services ensures a practice gets paid correctly for the services rendered.
Understanding the Common Types of Medical Posting
There are primarily 4 types of payment posting. These include:
Electronic Remittance Advisory (ERA) Posting
This type of posting involves loading the files into the billing software, identifying exceptions from the batch runs and correcting them.
Manual Payment Posting
In this type of posting, payment information from scanned documents (EOB) is posted to each patient accounts. Every aspect of payments such as write-offs, adjustments and balance transfers are taken care of manually.
Posting Patient Payment
This is the stage when patient payments are accounted for so that there are no cases of inflated AR. Payment is accounted from patients via different channels such as checks, POS cash collections, credit cards, internet banking etc.
Denial posting
This part of payment posting services comes into action when claims are denied. It includes actions such as sending bills to the secondary payer, carrying out balance transfer to the patient account, managing write-offs/ adjustments as per provider policies, and assigning denials to work queues.
How Does Payment Posting Fit into Medical Revenue Cycle?
Payment posting is a critical part of the revenue cycle: Its importance lies in the fact that helps a provider see the daily trends within their practice and seize all the opportunities to improve incoming revenue. A well-oiled payment posting process can make the overall medical billing process seamless and increase profits.
The six common ways by which they make the billing process efficient are:
- Map data from both EOB’s and ERA’s and ensure the payments match
- Reroute claims denial issues to the denial management team for review and resubmission
- Move fees not borne by the payer to patient’s responsibility to recover money from the patient
- Take care of adjustments and write-offs as well as flag improper contractual adjustments.
- Be in charge of in-person collection issues such as prior authorizations, non-covered services, and co-payment or deductibles or upfront collection at the point of service.
The commonly followed process for payment posting is as follows
- Receive payment file from payer and review it
- Key in payments in the software under respective patient accounts
- Analyze EOB’s for over payment amount or under payment
- Ensure the posted payment amount is the same as the actual deposit amount
- Post write offs, denials, adjustments etc. Post balance to patient account
- Inform concerned team about denials/underpayments
Also Read: Payment Posting and Its Significance in Medical Billing
When Rules and Technology Change, It Impacts Payment Posting!
Over the last few years, the healthcare landscape has undergone major changes: Every time a change takes place, it impacts payment posting in telling ways. Firstly, posting professionals or posters need to deal with a whole lot of sophisticated and improvised technologies, which keep coming soon enough. Secondly, they need to reconcile themselves with multiple new payment models bought about by the changing rules and which includes bundled payments, shared savings, and value-based reimbursement. And lastly, they are left to handle the impact of transitioning from one billing system to another which usually happen more often that they would want. All these together have compounded problems for posters.
Best Ways to Streamline Payment Posting
Change is a constant in the health industry: Therefore, the best way for providers to get control over payment posting is by trying to take changes that keep happening into their stride. To ensure this they need to:
Have Efficient Staff to Handle Payment Posting Service
Your payment posting process is as good as the staff you have at your command. Therefore, an evaluation of your process should always begin with evaluation of your staff. Firstly, you can’t run a process smoothly, if you do not have enough staff, and secondly, and perhaps most importantly, you need to have the right staff i.e. staff with adequate experience. With experienced staff you can look forward to maximum productivity and accuracy.
This is extremely important when you are processing huge volume of payments every day. Also, it is always easy to train an experienced staff than a fresher. Given the constant change in payer guidelines it’s important to have staff who adapt quickly to changes.
Ensure Staff is Tech Savvy
It’s imperative for posters to adapt to complex posting technology solutions as they keep evolving. By being open to technology adoption they play the role of facilitators particularly when providers transition from legacy to advanced patient accounting systems. This can help them reconcile EOBs and remits without any confusion especially when it needs to be done across various IT systems. Migration of patient accounting system leads to splitting of ERA files across systems and therefore proper knowledge of the splitting and reconciling across systems can be very helpful.
Create Organizational Awareness Among Staff
Medical posting is no longer about data entry proficiency: In fact, it is important for posters to have extensive knowledge about how different departments across the organization work. This would help them do their jobs properly as well as create the kind of seamlessness required to improve overall revenue operations. For instance, the posting team often receives mail that actually should be addressed to other departments. Knowledge of the organizational structure helps in redirecting the mail to the right department and create process efficiency.
Ensure Staff Have Updated Payer knowledge
It’s important for medical posters to have end-to-end knowledge of updated payers rules. In other words, they need to regularly go through different payer websites, clearinghouses, or intermediaries, to understand the nitty-gritty’s of payer guidelines. Some key knowledge they need to have include:
Awareness of interpreting provider level adjustments (PLB) and how different payers use them. For instance, different payers use different methods for explaining this on EOBs. Once posters EOBs are generated on Mondays but takeback i.e. overpayment recovery are issued on Fridays.
Awareness of different payment and posting methods: This is particularly important with payers paying through EFT and desisting from utilizing ERA files. In this case, the onus is on the poster to identify and reconcile with the correct EOB, as well as reconcile with the deposit.
Identify and correct reconciliation issues: This mostly happens when payers release the ERA file before they deposit the money. This may lead to issues especially when it comes to reconciling between the finance department and patient accounting. Therefore posters always have to be on their toes.
Interpret denial accurately: This is important because when it comes to denial posting, all payers do not use the common HIPAA Claim Adjustment Reason Codes (CARCs). It therefore falls upon the poster to adjust the payer proprietary codes to the HIPAA CARCs to ensure the claim is mapped to the correct work queue.
Keep a tab on offsets: Some payers offset payments but do not send account numbers on time. In some cases, it takes them several weeks or even months to send the numbers. It once again falls on the posters to keep a close eye on those payments and reconcile it in due course.
Keep a close eye on Claim Adjustment Reason Codes (CARCs): More often than not payers may use new codes (remittance advice remark codes, claim adjustment reason codes etc.) to explain certain aspects of payments. When this happens, the responsibility is on the poster to work closely with the revenue cycle department to map the codes correctly.
Closing Thoughts
To overcome the challenges of a constantly changing medical landscape, it’s important to have strong payment posters and an advanced and well-monitored process in place. Given that experienced posters come at a cost, it is advisable to hire people with less experience but with the ability to learn quickly and having strong technical and critical thinking skills. While you can train them quickly, they will be more inclined to adapt to the changes fast and help your organization grow with the changes. Is your organization ready?
Who are We and What Makes us an Expert?
OutsourceRCM is a healthcare BPO service provider with over 10 years of experience in providing a range of specialized back office services to US-based healthcare practices. One of the areas we specialize in is payment posting services. Our service is driven by experts with considerable experience in critical aspects of the service which includes verifying insurance and maintaining referrals, insurance billing charge extraction, charge entry, follow up on account receivables, and post patient payments and balance daily deposits. Get in touch with us to know more about our services.
