Payment Posting

HANA HealthCare, the process of payment posting in medical billing is a critical focus for our Operations management team. Payments received from both Payers and Patients, which correspond to claims, are entered into the client's medical billing system to facilitate claim reconciliation. HANA HealthCare also performs electronic payment posting within the medical billing software and manually addresses any exceptions (fallouts) to ensure that no payments are overlooked. The posted Electronic Remittance Advices (ERAs) are archived either in the billing system or in a Document Management System (DMS) for future reference.

Insurance Payment Posting: All payers provide either an Explanation of Benefits (EOB) or an Electronic Remittance Advice (ERA) for claim payments. The medical billing personnel promptly record these payments into the appropriate patient accounts, aligning them with the specific claims for reconciliation purposes. Payment posting is conducted in accordance with client-specific guidelines, which outline the thresholds for adjustments, write-offs, and refund protocols. When there are delays from the client’s office in depositing Payer checks or in sending ERAs and EOBs for posting, it can lead to a negative balance for that claim, misrepresenting the actual situation. This misrepresentation can inflate Accounts Receivable (AR), leaving Physicians unaware of the true revenue owed to them.

Patient Cash Posting: There are various reasons a patient may be required to cover part of their expenses, such as co-pays, deductibles, and services not covered by insurance. If the amount owed by the patient is minimal, the Provider may establish a policy for write-offs. Conversely, if the amount is substantial, it should be collected from the patient either before or after the services are provided. Patients generally make payments via checks or credit cards (through patient portals), and it is essential that these payments are accurately recorded against the claim to prevent inflated AR and ensure proper claim closure.