You’ve done the service, sent the claim, now time to post the incoming payment. This is not a step in the revenue cycle to be taken lightly or overlooked. There are a few keys to optimizing payment posting:
- Utilizing electronic remittance advice (ERA) to post directly to the electronic practice management (EPM) system. This removes a degree of human error in regards to data entry. Whenever possible administrators should look to combine electronic funds transfer (EFT) with ERA submissions. This allows clinics to see quicker payments. Staff will still need to verify EFT matches ERA and reconcile each payment. When looking to collect payments via EFT, administrators should be aware of any additional fees payers may add on for this feature.
- If manually posting payments to EPM assure high attention to detail and reconciliation. Staff should be trained on how to read the explanation of benefits (EOB) and remittance advice for any payments not in full.
- Despite manual or automated payment posting, clinics must assure payments match the expected amount to be collected. Whether the amount is equal to the clinic’s fee schedule or the contract agreed amount. According to a 2017 MGMA poll, only 20% of respondents compared reimbursement to contracted rates on a daily basis. Almost 30% were unsure or were unclear on if they compared incoming payments to contracted rates. Administrators and managers should perform due diligence to guarantee they are being paid in full for their services.
- Review adjustment reasons and prepare for denial management and appeals. Administrators should train staff to not accept incoming payments or denials as is without assuring all avenues for full collection have been sought. Best practice is for adjustments to be made during the payment posting process, not before.
- Allocate payments by line item incoming from payers. This helps with tracking, reconciliation, and