Basics of Payment Posting
Payment posting is an integral part of the revenue cycle management (RCM) of any healthcare organization. As the name suggests, payment posting involves posting the payments and their reconciliation. The billing team will post the received and denied payments into billing software against the submitted claim. If you have an efficient payment posting team, they will uncover trends behind claim denials, will find out non-covered services, and requirements of prior authorizations. All these issues can be discussed with the medical billing and coding team to improve the clean claim percentage and reduce the denial claim percentage. With accurate payment posting, you can catch any billing inefficiencies or issues quickly, making the entire billing process smoother for everyone, from the front office to the back-office staff. Being such a crucial process of RCM, we discussed how accurate payment posting can lead to improved billing efficiency.
If you have a skilled and experienced billing team member who can understand EOBs (Explanation of Benefits) and ERAs (Electronic Remittance Advice) then you can reconcile the payment accurately. Most of the times providers either consider their claims as paid or denied. Most of the time, part of your claim is paid by the insurance carrier and part is denied giving a denial reason. You must be able to read every line item to find out such denied payments in every claim. Sometimes one procedure code might have been denied due to the absence of a modifier or used as a duplicate. If you are able to reconcile your received payments, you will be able to receive more accurate insurance payments for delivered services.
An important aspect of payment posting is registering why the payment has been denied. Accurate payment posting practices suggest mentioning every denied payment with an accurate denial code along with a remark code, if available. This activity does the groundwork for the denial analysis and resolution team that works on such denial reasons. Most practices focus on submitting claims and expect payment for delivered services. Payment posting helps them to find out why their claims are getting paid, what is the allowable amount for specific procedure codes, and why claims are getting denied. With proper payment posting, your team can rework denied claims to receive accurate insurance collections.
Finding Patient Responsibility
With more and more patients adopting high deductible plans, patient responsibility has increased exponentially in recent times. If your practice conducts eligibility and benefits verification for every patient visit then you can find the exact amount of patient responsibility before rendering services. Otherwise, you have to depend upon payment posting activity to find out exact patient responsibility and then charge patients accordingly. Payment posting gives your exact patient responsibility like co-payments, unpaid deductibles, and non-covered services. You can raise an invoice for such unpaid patient payments to increase practice collections.
Just receiving checks from insurance carriers doesn’t mean that everything’s fine. You have to evaluate your payment posting process on a periodic basis. Every payment must be documented properly to ensure accurate collection of insurance and patient payments. Medisys Data Solutions is a leading medical billing company providing complete billing and coding services for various medical billing specialities. Our expert payment posting team not only posts payments accurately but sends denied payment details to denial resolution team to rework on such denied claims on priority. To know more about our medical billing and coding services, contact us at email@example.com/ 302-261-9187