There are many important administrative and clinical steps that contribute to capturing, managing, and collecting patient service revenues that can help practices maintain better control over the revenue cycle and overcome their most pressing financial challenges.
Most medical practices deal with a large number of claims every day, and if they’re not accurate, more time is required to fix the problems, which means, the longer it takes to get paid. Oftentimes, practices are saddled with a backlog of payments to post, or they lack electronic remittance advice (ERA) file enrollments and do not have clear insights into why claims are getting denied.
This is where payment posting comes in. By having a strong process in place, practices can identify payer problems – such as medical necessity denials, services that are not covered or when prior authorization is required – from the start. These issues can then be quickly addressed before they delay care or result in costly billing mistakes. It can also help with reconciling data from explanation of benefits (EOBs) and ERAs to ensure it matches actual payments.
Payment posting can also eliminate billing problems and enable your staff to be more efficient in a number of ways. When not done correctly, for example, payment posting can extend the number of days bills are in accounts receivable, and requires more staff to fix errors, contact insurance companies or patients, process write-offs and make adjustments — all of which results in higher labor costs and lower efficiency rates that cut into practice profitability. Further, if payments are not posted in a timely manner, billing systems may send statements to patients who have already paid, causing confusion and frustration among patients, and forcing refunds or credits to be issued.
A variety of functions in a medical office – from front office and patient services to billing and claims – are impacted by payment posting. By putting a greater focus on this critical part of RCM in the post-COVID era and working to improve these processes, practices have a great opportunity to positively impact their overall revenue cycle. A focus on daily payment posting will allow practices to catch and correct billing and coding errors before they become more problematic, further streamlining billing procedures to improve cash flow, and taking unnecessary pressure off staff. The end result is overall improved financial performance.
About the Author
At Greenway Health, a leading health information technology and services provider, Marvin Luz serves as senior director, Greenway Revenue Services. With more than 13 years of experience in the ambulatory EHR and practice management market, he oversees the daily billing operations of revenue services for customers, ensuring compliance with divisional established policies and protocols, adherence to government and insurance payer policies and assurance of customer conflict resolution. In addition to his daily responsibilities, he also leads the Patient Call Center and Patient Accounts Receivable teams at Greenway.