Inaccurate payment posting can lead to financial losses. When payment posting is not done meticulously, a provider suffers as the payment for specific claim goes missing, in spite of getting paid. Imagine spending days behind a claim, and simple errors urging to repeat the entire process.
Here are few scenarios of incorrect payment posting.
- Payment applied to the wrong patient: While posting the payments from EOB at times wrong invoice number /patient ID is mentioned on the EOB. Inaccurate payment posting happens here, as the payment is adjusted for a wrong patient.
- Payment not applied: Bulk checks can make the payment posting bit tedious. It can be human error or negligence on the part of the poster, and payment for a claim is never updated. The payment poster has the responsibility to update the check details and maintain a file to enter details of a check, even when accurate and adequate info on the claim is not present.
- Balance not transferred: Patient responsibility is not mentioned in EOB, and many front office executives fail to check this when the patient visits the doctor. Since no information of copay and deductible is mentioned, patient responsibility is not taken into account, and the claim is considered to be partially paid.
- Incorrect Adjustment: When posting an insurance adjustment to the system, for instance, $90.00 adjustment can turn out to be $9000.00 adjustment due to negligence.
- Incorrect denial posted: When posting an insurance denial to the system sometimes the user is unable to identify which accurate denial reason should be used. They may select the wrong denial code.
If optimization of RCM is what you look at, then it is time to find ways to avoid inaccurate payment posting. Accurate payment posting helps in hastening the turnaround time, and denial management happen faster.
Steps to Prevent Errors
A Reliable medical billing service often knows how crucial is accurate payment posting, and makes use of several methods to cut it down. Here are certain points to keep in mind:-
- Check if payment entered and collection received a match.
Validate the amount received with the amount billed. This will help you to know whether the amount received is partial or a full payment.
- Compare contractual adjustment and the remittance advice
Check for contractual adjustments. This can be done by checking the remittance advice. You will get to know why a partial payment has been made.
- Patient responsibility and remaining balance should be in tune:
Check for the patient responsibility. The details must be in the EOB itself.
After all this, you should be able to get what you have billed for. If not, then the claim has to be reprocessed. The checkpoints help in ruling out the financial loss that tend to occur because of errors in payment posting. After all, it is the payment that the entire medical coding and billing process is after. Any imprecision can only mean precious time and efforts wasted.