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Payment Posting Is a Critical Part of the Medical Billing Process

December 14, 2016

M-Scribe Payment PostingWhen it comes to medical billing, most practice administrators tend to focus on coding and documentation as the main spokes in the billing wheel. Payment posting seems like an after thought, something that happens after the “real” work of medical billing ends. After all, you’ve done the hard part and got the payments in the door. 

But that view gives payment posting short shrift—accurate posting is actually one of the most critical functions in revenue cycle management and overall profitability. And when things go badly, the effects downstream can be financially catastrophic. 

Why is accurate payment posting so important in medical billing?

It should be self evident that accurate payment posting is important, but take a look at three real-world examples of just one posting error, in this case, a $100.10 contractual adjustment on a surgical procedure entered as $10,010 due to a little slip of the finger—

  • There is now a $10,010 credit balance on the patient’s account. This means the practice will never collect any money from that patient for her share of the procedure, which could be thousands of dollars with today’s high-deductible health plans. 
  • The practice’s accounts receivables are falsely deflated. Credit balances are subtracted from accounts receivable in financial reports, which means that the practice’s receivables look $10,010 better than they actually are—and potential billing problems are obscured by the inaccurate numbers. 
  • The patient will naturally receive an inaccurate statement. While a patient receiving an inaccurate credit is less likely to be upset than one being billed for fees they do not owe, it still suggests to the patient that your billing department isn’t very conscientious about financial matters. That’s not a reputation you want your practice to have. 

In the day-to-day processing of payments, posting is also your first line of defense when it comes to potential problems with payers. If they do their jobs well, your payment posters will be diligent about uncovering trends behind denials for medical necessity, non-covered services, and prior authorization, for example, and move any issues up the chain to be handled with other members of the coding and billing team.

Related Article: 4 Tips to Prevent Late Patient Payments for Medical Practice

How should payment posting fit into overall revenue cycle management?

Whether your payments are handled in-house or you use an outsourced billing service, your payment posting should be an integral part of the overall revenue cycle management:

  • Posting and reconciling data from both paper EOBs and ERAs and ensuring electronic deposits match payment totals. 
  • Identifying line item denials for medical necessity, non-covered services, and prior authorization and reporting any trends to management to head off potential ongoing process errors in the billing cycle. 
  • Spotting issues with window collections, such as failing to collect deductibles or copayments, when processing insurance remittances. 
  • Accurately moving balances to patient responsibility and ensuring prompt patient billing
  • Processing write-offs and adjustments and investigating unusual contractual adjustments, moving them up the management chain if problematic trends are identified. 
  • Ensuring that denials are correctly reworked and resubmitted to payers in a timely manner. 
  • Identifying claims with secondary payers and processing claims for any remaining balances. 

When payment posting is done well, the benefits to your practice are obvious—improved cash flow not least among them. You can also expect better overall collections when billing problems are spotted early and addressed promptly, secondary payers are billed accurately, and patients receive prompt and accurate statements. It’s a win-win for your practice all the way around. 

If you have questions or concerns about your payment processing, or are looking for a more efficient and cost effective way to manage your billing and collections, talk to the medical billing experts at M-Scribe today for a free consultation and billing analysis. 


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