Healthcare billing is all about recording health services and capturing relevant codes. This then helps them create claim applications that act as a receipt for payments. But sometimes due to the complex billing nature, the payment record is neglected, resulting in less revenue generation than you deserve. So what exactly is payment posting in medical billing?
When you provide health care to insured patients, you receive payments from their respective coverages. This is a payment posting from other parties to your account. But it is worth considering that hospitals lose a sufficient amount of revenue at this stage. So why not pay attention to posted or rejected payments to find out the shortfalls?
Here we will dive into this crucial aspect of medical billing where you will see the outcomes of your negligence towards payments and some strategies to adopt an efficient posting method. Stay tuned if you want to maximize your revenue generation capacity.
5 Role Players Of Payment Posting
Since every healthcare treatment is recorded and has to be paid, there are many payers when we talk about the cycle of payment posting in medical billing. If you think that only insurance payers make up most of the part of payment posting, you are wrong. Other stakeholders are also involved in the process, which collectively helps a healthcare facility collect ample revenue. These participants are:
Billing Specialists
Medical billers are the key players in payment posting because they take care of paid and delayed bills and claim applications. They review the Explanation of Benefits (EOB) forms and Electronic Remittance Advice (ERA) files received from insurance companies. Billers conduct regular payment postings, find out claim denial reasons and update claims to the accounts of the patients.
Insurance Payers
They are another crucial element of payment posting in medical billing. Insurance payers are the ones who provide files like EOB and ERA including all the details about paid claims, unpaid applications, and rejected forms.
Healthcare Providers
Though they don’t have a direct impact on payments, healthcare providers like doctors, physicians, hospitals, and clinics hold importance in the process. They can review the payments received from third parties for the services they provided as well as any financial aspect that needs to be taken care of.
Learn the Entire Process of Medical Billing
RCM Team
The staff managing the entire revenue cycle makes up this team. They all work together to keep records of posted and received payments, delayed bills, unpaid claims, and other concerning payments-related matters. RCM staff is responsible for monitoring payments, finding out errors leading to claim denials, and making strategies for quick payment posting in medical billing.
Patients
Last but not least, even after most of the portion of health treatments is covered by insurance companies, patients owe some amounts in terms of copayments and deductibles. At the end of medical billing, they make the bill payment which marks the process finally complete, and thus ends the entire revenue generation process of an individual patient. Their payments add a boost to the revenue.
6 Tips To Improve Payment Posting In Medical Billing
Who doesn’t want more revenue? When collecting your bills in the healthcare department, you will experience many challenges. Sometimes patients don’t make payments early on and other times their bills are gone to debt, which delays the payments. Claim denials are another difficult situation where your applications are rejected based on any mistake.
Overall, these different obstacles create a barrier between you and the strong financial ability of your hospital or clinic. So let us tell you some proven tips that successful healthcare facilities use and by following these secrets you won’t let any of your revenue miss out.
Automate Payment Posting Process
With the advent of technology, you must also move forward. Make use of updated tech systems for billing. Automate your payment posting in medical billing using specific softwares, which results in reduced manual data entry errors, misleading postings, and tracked payment statuses.
Regular Training
Make sure your staff is educated enough to conduct payment posting responsibly. Emphasize their understanding of EOB and ERA files in detail so that they know the difference between paid and unpaid amounts. Make them aware of the latest healthcare revenue updates, claim errors to avoid, code revisions, and payer requirements to manage payments as a whole.
Electronic Remittance Advice
One thing that you must do as a biller is to ask insurance companies to send ERA files electronically. These files are directly sent to your systems, can be imported easily, and contain fewer mistakes than manually created EOB and ERA documents.
Clear Communication
Communication is the key to revenue generation. When you are working constantly with an insurance company, you must establish clear communication protocols. This proactive approach will help you identify claim errors, resolve payer objections early on, and request supporting documents to make payment postings in medical billing more efficient and successful.
Monitor Key Performance Indicators (KPIs)
Regularly track and monitor payment-related benchmarks to achieve your financial goals, including:
- Posting accuracy
- Turn around time
- Denial rates
- Clean claim rate
- Aging of accounts receivable
- Payer mix distribution
- Collection ratio
Using KPIs will keep your efforts on a consistent path. It helps you find out your weak points and lets you receive more payments avoiding your past mistakes.
Regular Audits
To make sure posted payments are complete, perform routine audits and reconciliations. To find any inconsistencies that need to be fixed, compare payments posted in the billing system with the related EOB/ERA documents.
Mastering Payment Posting
Payment posting in medical billing is not a simple job. Lack of attention and you lose hundreds of dollars. So to get you the revenue you deserve, we have created this guide to help you understand how this process works, what mistakes you might be making, and what further steps you can take to bring success to your revenue collection.
We hope we have solved your confusion regarding wasteful payment activities. Instead, follow the approaches we mentioned and see more revenue coming towards your healthcare facility.