Payment Posting Services For Accurate ERA Posting And A/R Control
Payments posting is the first point at which any denial and underpayment can be detected in a claim. At UControl Billing, we post your ERA and EOB payments line item-wise, match the adjustments with the appropriate ledger, reconcile each deposit to the bank account, and detect every short payment at its earliest point. We are based in the USA and handle your entire revenue cycle, so the postings will be handled by the same team.
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Payment Posting Determines Whether You Will Get Paid What You Earned
Posting seems like a clerical task and hence it is underrated. The remittance is what the payer claims he/she has paid, corrected and why there were corrections done. This is where the documentation starts with all the other aspects of the process. Errors made during posting are much worse compared to a clerical task. Denials that are posted as contractual adjustments will never be questioned by anyone because they will already have been posted. Short-pay that is not compared to the allowed amount and contractual rate will eventually be your lost revenue.
Underpayment is an example of this. Underpayment occurs when the payer sends you less money than your contracted rate, and it only comes out during comparison of the 835 allowed amount to the contracted rate, which is not a task many teams undertake. Once the short-pay is posted without any inquiry, it will set up a new norm of payment based on underpayment that eats away at your contracts claim by claim. Posting becomes a place where such comparisons can be made or not.
What Is Payment Posting In Medical Billing?
Payment posting is a process in the revenue cycle where all insurance and patient payments are posted against their respective claims, where all adjustments and write-offs are applied and all denials and underpayments are marked upon receipt.
At UControl Billing, we offer payment posting service for US healthcare providers through accurate line-item ERA and EOB as part of our full-fledged revenue cycle management service so that your cash flow, denials, and patient account balances are accurate right from the time of posting.Another term used to describe payment posting is cash posting or receipt entry, which occurs after the claim is adjudicated. There are two kinds of input for this process, both being the output of the payer’s decision. The ERA or Electronic Remittance Advice is the 835 electronic remittance, while the Explanation of Benefits or EOB is the paper or PDF equivalent that has to be manually keyed by someone. The information in both files is the same: the allowed amount, the payment, patient responsibility, and adjustment codes.
In posting, the account is made accurate and contains a list of exceptions. Each entry will be correlated with its claim, the amount will be billed, the contractual adjustment will be written off, and any balance will be transferred to either the patient or the secondary insurance company. In the case where there is a denial or underpayment, it will be noted and processed instead of being absorbed by the system. The posting process does not reverse the denial or chase the balance owed.
How The Payment Posting Process Works
The payment posting process has seven steps, through which the payment is moved from the payer record to the balanced ledger. These transactions are carried out at each step, and all exceptions are routed correctly.
Receive the remittance
The 835 ERA, the paper EOB, and the patient payments come in from the payer and the clearinghouse.
Match to the claim
Each line is matched to its claim based on the payer claim control number and the service dates.
Post the line items
Allowed amount, payment, and the CARC code are posted to the claim.
Implement adjustments
Write-off entries fall into the allowable range; the PR credit adjustment is entered into the account of the patient.
Identify discrepancies
Denied claims and underpayments are flagged for the attention of collection.
Process secondary / COB
A balance, when outstanding, is the signal for the secondary claim to start.
Match posting to bank
The postings are correlated with the bank deposit using the EFT trace number.
ERA vs EOB Posting: Auto-Posting And Manual Posting
Primary entity pair, and how the payment arrives at the ledger in two different ways. And we do both, where applicable, eliminate manual posting for those who are eligible for it.
ERA–Electronic (835) auto-posting
ERA file is an ANSI 835 file, which is the federally-mandated standard format of the payer's decision. Once you ingest this file in your system, all payments and adjustments are automatically posted against the corresponding claims, and deposit is reconciled based on the trace number. However, automatic posting is not equal to unattended posting: zero-pay remittance, denied claims and non-matching lines still need to go through the work queue.
EOB–Manual (paper) posting
Paper/PDF explanation of benefits does not have a machine-readable version, therefore, all lines are manually verified and posted against their corresponding claims. This process is time-consuming and increases the probability of errors, that is why reimbursement claims are processed more quickly once the provider starts using electronic remittance. Enrollment in ERA/EFT with each payer is a part of our onboarding process, that is why manual posting is applied to several payers only.
Payment Posting Vs Denial Management and AR Follow-Up
Posting is the place where the issue is first recognized and labeled. Recovery activities following that will be done within different stages and maintaining the boundary is the reason for accountability for the stage.
| Stage | What it does | Where the work goes next |
|---|---|---|
| Payment posting | Tracks all payments and adjustments, notes denials and short pays | Detection only; refers the exception further |
| Denial management | Appeals the denials and reverses them posted by posting | Manages its own appeal and resubmission |
| AR follow-up | Chases aged and underpaid amounts until it solves the issue | Manages recovery of the entire underpaid pool |
The underpaid claim gets noticed and referred; we don’t call it a recovery after posting. This aspect is critical since an ignored short pay creates revenue risks, just like you confusing the two, this way you’ll create the impression that it was managed, while actually it was detected only. UControl handles posting, denial management, and accounts receivable follow-up all at once. The posting alerts get referred to a group authorized to manage all of them together.
Common Payment Posting Errors That Cost Practices Revenue
There is always something that causes any problem and by finding it, you will be able to find how to solve it in the future. The following are the reasons for which the careless handling of the remittance results in income loss.
| Payment Posting Errors | Description |
|---|---|
| Denied claims concealed within the remittance | The denial is reflected in the 835 through the CARC. It is quickly filed and goes unnoticed because of its lack of appearance as an alert. Nothing happens since no one even thinks about filing an appeal since there has been no denial. And then the opportunity for appeal goes away due to inactivity. This particular claim receives no payment and makes no attempt at appeal. |
| Short payments that appear as such | Payer makes a payment, which is lower than what your agreement provides and it is posted as a paid claim. There is nothing to compare to the amount paid because there is no difference between the amounts allowed by the 835 and the contract. The amount is reduced, thus creating underpayments for all similar claims. |
| Misposted balances and bloated AR | The write-off based on the contract, or misapplied payments, leaves balances posted incorrectly. AR becomes bloated by non-existent amounts, the reports become inaccurate, and employees waste their time collecting balances that were not collectible from the start. |
| Missed secondary and over-collection of patients | In case the residual balance is not shifted to the secondary insurance company or coordination of benefits, a clean claim will not be submitted and hence the revenue will just stop coming. The problem is even more damaging when the billing is done based on the wrong balance – a patient will be charged with what they do not owe |
Benefits Of Accurate Payment Posting For Your Practice
Proper posting delivers the impact throughout all subsequent steps in the process. It is the reverse process from that described above – identical mechanisms used, but now working for you.
Payments come faster
Since daily transactions are posted according to the daily cycle, then your payments arrive in your account according to the expected schedule, not haphazardly.
Each and every CARC is thoroughly scrutinized, which means that any denials are caught and directed when there is plenty of time left to file an appeal. You have all the time on your side to begin your recovery.
Right secondary billing procedure
When your balance is correctly transferred to your secondary or COB, then your next claim is filed in time, and secondary insurance revenues do not get lost in the process.
Statements your patients trust
Accurate posting results in accurate CO/PR separation, and in turn, statements accurately representing how much the patient still owes, leading to fewer billing disputes and refunds and a trusted statement amount.
Accounting figures that you can trust
If all the transactions, adjustments, and write-offs are properly recorded and reconciled with the bank, the figures that management sees represent an accurate reflection of the true figures, and all decisions are based on facts, not assumptions.
Rate integrity preserved
By comparing every allowable charge to the contract rate at posting, we prevent the accumulation of short pays, thus ensuring that the rates you negotiate are the rates you get.
Our Payment Posting Services
Five related activities carried out by the same American team that writes, submits, and recovers from your business. One common standard, one person you can hold responsible for it all.
Reconciliation and reporting
All ERAs reconcile to the accounting ledger and to the bank deposit through EFT trace number, with adjustments on the provider side tracked to guarantee that the posting matches up with reality. Each month’s report will show what has been received, posted, adjusted, written off, and the discrepancy, giving reason for money movement.
Insurance payment posting
Posting line-by-line of ERA and EOB of allowed, paid and CARC notes against each individual claim, so that your bookkeeping reflects exactly how each insurer processed each claim, code by code.
Patient payment posting
Copayments, deductibles, coinsurance, and self-payment against outstanding balances, so that each bill displays the correct outstanding balance and does not contain anything you did not collect from them.
Adjustments and write-offs to your contract
Adjustment based on the allowed thresholds relative to your fees and contract with each write-off recorded and verifiable as opposed to just taken on faith.
Denials and underpayment identification
Identification of denials and underpayments during posting and directing the denial and/or underpayment through the appropriate collection avenue, giving you the opportunity to identify a denial while it can be resolved.
UControl KPIs for Payment Posting
Posting is quantifiable, and here are the metrics posting impacts. All numbers provided are industry benchmarks we strive to achieve, not guaranteed by UControl.
Posting accuracy99%+
Matching line items to remittance The verification of the claim ensures the ledger and the patient balance are accurate right away.
Posting cycle 24 to 48 hours
Time from receipt to posting Fast cadence allows getting each balance to the next stage timely without any delays.
AR aging 30 to 40 days
MGMA 2024 / AAFP range Correct posting helps to keep AR clean from fake balances that increase the total.
Capture rate of denials during posting
Towards 100% Denials marked out of received Reading each CARC allows for recognizing the denial when the period of appeals is open.
How Payment Posting Fits In The Revenue Cycle
Payment Posting
The process of posting relies on charge capture and billing that happen upstream and denial management and patient billing that occurs downstream. Being included into the overall revenue cycle management, posting requires the same standards to be used throughout the entire process and avoid loss during the handover.
Accurate Posting
Payments are recorded correctly to maintain clean financial records.
Revenue Visibility
Clear payment data helps identify outstanding balances quickly.
Fewer Errors
Proper posting reduces billing issues and improves collections.
Payment Posting By Practice Type And Specialty
| Discovery and free audit | How your remittances post currently and do a free posting audit, uncovering hidden denials, undetected underpayments, and reconciliation issues. |
| ERA, EFT, and integration | Enroll in ERA and EFT with each payer, set up auto-posting, and integrate with your current systems, making sure the file goes directly into the accounting system. |
| Go-live with oversight | Posting goes live, and the account team monitors accuracy, turnaround, denial and reconciliation issues, and reports what emerges every month. |
EHR and Practice Management Systems We Post In
We post into the system you are currently using, and we put in place the plumbing that most vendors ignore. When ERA and EFT have not been enabled yet, we enroll for each payer and configure the auto-posting so that volume gets posted manually.
Monthly Remittance Volume: The Number Of Payments To Post And Reconcile
We post into the system you are currently using, and we put in place the plumbing that most vendors ignore. When ERA and EFT have not been enabled yet, we enroll for each payer and configure the auto-posting so that volume gets posted manually.
Payer mix: number of payers and their unique quirks of 835
Manual versus ERA split: manual entry of EOB is costlier than automated posting
Level of reporting: standard reporting versus variances analysis
Number of sites: each site adds an inflow to consolidate
Underpayment analysis: comparison at contract level per claim.
How To Get Started With Outsourced Payment Posting
Three things will get you from that initial call to posting operations being run by us.
Discovery and Free Audit
Understand how your remittances post currently and perform a free posting audit, uncovering hidden denials, undetected underpayments, and reconciliation issues.
ERA, EFT, and Integration
Enroll in ERA and EFT with each payer, configure auto-posting, and integrate with your existing systems to ensure files flow directly into your accounting system.
Go-Live With Oversight
Posting goes live while your account team monitors accuracy, turnaround, denial trends, reconciliation issues, and provides monthly reporting.
Why Practices Choose Ucontrol For Payment Posting
A revenue cycle company in the United States where the entity responsible for recording your payments is also responsible for resolving any denials or underpayments discovered in that process, under one standard, without any handoffs between vendors to ensure it does not slip through the cracks.
US-based & RCM-enabled
Underpayment discovery during the posting process
One standard, no gaps in transfer of responsibility
Medical Billing Certifications and Compliance Standards
We hold the certifications that payers and auditors look for, and our coders carry the right credentials. It’s not the most exciting part of the work, but it’s the part that keeps your claims on solid ground.
Explore Frequently Asked Questions
Payment posting is the practice of matching all payments by the insurer and the client to the corresponding claims, making the necessary adjustments and write-offs, and marking the denials and underpayments when they are received. It is referred to as cash posting and starts once a claim has been adjudicated to generate a proper ledger as well as exceptions that need attention from the recovery team.
They both show how a payer has handled a certain claim. The ERA stands for electronic 835 remittance and is a standardized file that a billing software can use to post a payment automatically. The EOB stands for explanation of benefits and comes as a paper or PDF form. The two have the same information except that the ERA allows for automatic posting while the EOB requires manual input.
The auto-posting processes the 835 ERA file and posts the payments and adjustment postings to the matched claims, except exceptions of denials and zero-pays which go into work queue. Manual posting is based on paper EOB and each item is individually verified and posted manually. Auto-posting is faster and more accurate therefore the reason for conversion of payers to ERA as part of the onboarding process.
Posting is the point in time where denials come into light unlike notice. This is because denials are communicated through claim adjustment reason codes in remittance and should be processed appropriately at this point of time in order for it to be appealed in time, failure of which it is likely to be ignored in case of not being properly posted.
Cash posting is basically another name for payment posting which can also be referred to as receipt entry. This is the process of posting the payments made by insurance companies as well as patients to the correct claims and balancing and making appropriate adjustments to the payment postings to match the bank deposits.
Underpayments are detected through comparison of the allowed amount on the 835 with the rate you have in your payer contract. If the payer pays an amount that is less than the rate in your payer contract, the line will still post as paid, but only the comparison will show that it is an underpayment.
Yes. The outsourcing company posts your ERA and EOB remittances and patient payments into your current system, performs adjustments according to permitted thresholds, detects denials and underpayments, and then reconciles it to your bank account. In the case of UControl, payment posting links to the team responsible for denial management and AR and operates under one US-based standard.
We post into the EHRs that the practice uses currently – athenahealth, eClinicalWorks, Epic, Tebra (Kareo), AdvancedMD, DrChrono, NextGen, and many more. In cases where ERA and EFT capabilities are still missing, we perform enrollment on a per-payer basis and configure automatic posting so that you receive payments in your system without additional software installation.