The intelligent automation will open a batch, retrieve ERAs, import and identify any unmatched payments by looking at the DOS, charge amounts, CPT codes, etc. and will post the payments including any adjustment logic like OA23 adjustments and can add a Medicare secondary where a crossover claim has been received without the payer being associated with the patient account.
The automation will reconcile the ERA to the batch and close the batch saving the reconciliation reports to a shared drive location for future reference and emailing stakeholders that the process has completed.
Why Is Accurate Payment Posting Important
Payment posting allows medicals practice to receive full payment in the most expenditious manner possible.
The office administrator can receive a quick snapshot of payments in progress, for an overview of the practice’s financial picture.
An accurate payment posting and reconciliation process is critical to the practice’s existence.
The more reliable the payment posting process is the more money that consistently flows into the practice’s coffers.
Increase Revenue
Reduce Bad Debt
Decrease Overhead
Benefits of Payment Posting in Medical Billing Software
Payment posting and reconciliations that are done manually are time-consuming and fraught with errors. Payers may have non-standard EOB formats, and claim codes may also vary.
A manual EOB processing code error of just a decimal point could lead to lost revenue, or hours of time to locate the error.
State-of-the-art Medical Billing Software includes features such as Batch EOB posting, electronic claims submission, and automated patient statements that make the billing process more efficient.
Benefits of payment posting in medical billing software include
Matching EOB data against payments received
Accurate and timely EOB and ERA posting and reconciliation
Processing adjustments and write-offs against contractual agreements
Identifying non-covered service, denial, prior authorization, and collection issues to be rectified.
Claim denial management to quickly identify denials, rework claims, and resubmit
Applying patient Copay and move remaining outstanding balances to the patient's account for processing
Supporting Patient Payment Plan and Collection Agency workflows
Improving revenue cycle management
Eligibility/COB
The intelligent process automation will navigate to the payor portal and check MBI/Eligibility, and other payer information and make corrections to patient name, DOB, policy or plan mismatch if it exists at the payer level to resubmit the claim for reimbursement.
Authorization Denials
Intelligent automation will either submit a retro auth or Medical Necessity appeal with scholarly articles to try to overturn authorization denials.
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