EOBs and Payment Posting  – Important Part for Medical Billing Process

Understanding EOBs and Payment Posting Process

Strict attention to detail is crucial in effective medical Revenue Cycle Management. Efficient payment posting means practices account for all services provided, accurately submit claims to insurance providers, review information from insurers regarding claims, and coordinate claim payment posting and reconciliation with patient payments on a timely basis.

This ensures a strong cash flow, so the practice receives the maximum amount of reimbursement in the minimum amount of time. 

Why Is Accurate Payment Posting Important?

➤ Payment posting allows medical practices to receive full payment in the most expeditious manner possible.

➤ Claims are logged into the billing software, insurance payments are posted against claims, patients are billed for outstanding amounts, and patient payments are posted against outstanding balances.

➤ 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. It results in an efficient billing system and a healthy and reliable cash flow, with minimal administrative oversight.

➤ The more reliable the payment posting process is the more money that consistently flows into the practice’s coffers. This makes it far easier to assess future cash needs and develop accurate budget projections. 

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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. 

Best Practices

Benefits of payment posting in medical billing software include: 

Matching EOB data against payments received

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

How to Evaluate the Payment Posting Process at Your Practice

Your practice may seem to have an accurate payment posting process that results in regular receipt of payer checks, but you should still evaluate the process to maximize efficiency.

Your practice needs sufficient staff with correct posting skills, based on the volume of claims it submits. Check references, provide training, and review regularly. 

Leaving one person in charge of posting without oversight is an invitation to fraud. Separate the duties so that those who do billing are not in charge of receipts and collections.  

Be aware of how much revenue your practice is losing through write-offs. Ensure that write-offs are based on contractual agreements, and not just inattention to detail by staff. Audit the process regularly to look for lax procedures.

The best practice is to get payments posted and deposited as quickly as possible. This gets money into the revenue stream faster and eliminates the frustrating process of sending bills for payments. 

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Why Choose PrognoCIS for Payment Posting

One way to increase payment posting efficiency is to take advantage of the latest software technology from PrognoCIS. Our experienced practice management and revenue cycle management implementers can help your practice easily integrate software to manage your practice’s medical billing with a customizable workflow designed for your practice.

Other than getting the cool payment posting features mentioned above in our Medical billing software when you work with PrognoCIS you receive the following: 

With PrognoCIS, transition is a simple, cost-effective, and painless experience

We handle all system setup, documentation, EDI implementation, process coordination, and training at no additional cost. There are no medical billing software installation fees.  

Our implementation team guides you through a simple training program to teach your Billers, Payment Posters, AR Team members how to use PrognoCIS for their workflow in the most efficient way. 

Testimonials

What People Say

"I have been very pleased with the service I get regarding my billing with PrognoCIS. The team I am assigned with is wonderful! We communicate daily, we work together, all of my questions are answered and problems solved in a timely manner and we continuously work on strategies to make the process more efficient. I could not be more pleased and would highly recommend them to all of my colleagues."
"The team is very reliable and transparent in their billing activities. Denials are worked on to the best they could. Our billing manager, Dawn, always addressed any questions or concerns that we have. We communicate with her on a regular basis. Highly recommend Prognocis RCM."

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FAQs

EOB is generated by the Insurance Company (payor) when the provider submits a claim for the services provided by him to the patients.

Two to three weeks after claims submission, the medical practitioner receives a reply from the payor in the form of EOB. This is to inform them about their decision as to whether the claim will be paid or denied. The provider receives the EOB via traditional mail.  

If there is a payment associated with the EOB, it will be sent as a check via traditional mail by the Insurance to the service provider (Clinic).

If the EOB states that the claim was denied, the clinic billers are required to take further action like resubmission of information to the Insurance company.  

An ERA stands for Electronic Remittance Advice. It is the electronic version of the EOB.

Clinics must first register with the Insurance carriers to receive ERA. Even though the ERA is received electronically, the payment for the claim can be received by the clinic through various modes like Check, Credit Card or EFT i.e., Electronic Fund Transfer directly to the clinic’s bank account depending on how the clinic has registered with each Insurance company for receiving payment.

The advantages of ERA over EOB are that ERAs eliminate the paperwork overload, they are received on the same day and being electronic, eliminate manual data entry and further automates the payment process. 

An EOB or an ERA is important for healthcare providers and patients as it tracks medical claims and spells out payment responsibilities and denial details. It provides an accurate listing of services provided and their associated fees. EOB/ERA information typically explains the amounts, such as deductibles, co-insurance, and co-payments, that the patient is responsible for paying out of pocket.  

EOB includes the following information: 

  • Patient name 
  • Provider name 
  • Insurance provider/policy number 
  • Claim number 
  • Date of service 
  • Description of service/insurer’s service code  
  • Initial provider fees 
  • The amount allowed by insurance under its contractual fee schedule
  • Applicable co-pays and deductibles
  • Notification of potential patient financial responsibility 
  • Notice of claim denial and appeal process, if applicable 

If the patient has secondary Insurance, the outstanding amount may then be submitted to this secondary insurance, which could further reduce the patient’s responsibility.

After insurer payments are received, the medical office can proceed to collect any remaining amount from the patient. 

 

Our Range of Services to Facilitate your Medical Billing Process​

Revenue Cycle Management

Use our RCM services to process statements and handle your claims, while you connect with patients

Account Resolution Service

Accelerate patient communication for shorter billing cycles using our account resolution service.

EHR Integration

The most appropriate solution for enhancing the workflow and overall resourcefulness of a healthcare practice.

Credentialing

Quickly enroll your practice with third-party payers and begin seeing patients

Contact Us

We also offer a comprehensive package of our Premier features, including:

Have any questions? We’d love to hear from you

Call 408-873-3030 today to request a demo and learn more about EOB, ERA, and other payment posting features of PrognoCIS. 

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