If we had to review some of the things that make healthcare institutions successful, finance would be in the top three. The backbone of every business and service is money: funds to keep it running, hire the best workers, and offer the newest innovations and technology. Health institutions rely heavily on payment posting in medical billing to facilitate excellent revenue cycle management, and it has never failed. Here is a look at what this model entails and why it’s so important in healthcare.
What is Payment Posting?
Payment posting is one of the final processes of ensuring accurate financial records in healthcare facilities. It is the step taken to record payments from insurance companies and patients. It also helps individuals, patients, and insurance companies keep track of the entire procedure.
When patients get medical care in a hospital, the payment breakdown, including co-insurance, deductibles, and other expenses, is detailed in the Explanation of Benefits (EOB) and sent alongside other documents like Electronic Remittance Advice (ERA), which explains the insurance process. A well-executed payment posting process ensures that all remittance documentation aligns with the EOBs and the ERAs.
While the payment posting process often varies based on organizations, everyone follows a common approach, which has been summarized above. During this process, the insurance company is expected to review the financial obligations and pay based on the patient’s insurance coverage. After this, the patient gets a breakdown of the part they’re expected to pay, and all information will be recorded in their billing system.
At this point, individuals can review the details and report any discrepancies to be investigated. There are two major approaches to getting this done: manual posting and auto posting. As it sounds, the manual process is done by manually entering the details into the billing system. However, it is time-consuming and prone to errors if done incorrectly. Most institutions go through automated processes, where the ERA and other electronic data measures come into play.
Why Is Payment Posting in Medical Billing So Important?
To the everyday person, payment posting may seem like a back-end task, but most health care systems will tell you it plays a central role in ensuring a medical practice’s financial health. How? It is the foundation for tracking revenue, identifying discrepancies, maintaining billing accuracy, and so much more, which we’ll detail in this section.
Resolving Claim Issues and Errors
In the United States, errors in health insurance claims occur in nearly one in 5 claims, according to the American Medical Association (AMA). This percentage amounts to about 20% of claims processed inaccurately. This is an issue for all parties involved, and it is something that could be easily avoided if payment posting is done right. One of the most valuable aspects of payment posting is its ability to highlight patterns in denials, payment discrepancies, or payer-specific issues early enough. If certain codes are consistently underpaid or denied, the billing team can investigate and take corrective action. Other challenges, internal issues, secondary claims, write-offs, and adjustments can also be made before the process is finalized.
Accurate Financial Reporting
Several factors affect the profitability of healthcare systems, including administrative costs, the delivery of quality services, the need to keep up with technological innovations, and so much more. A good percentage of the funds needed to maintain this quality is obtained through patents and insurance settlements. Payment posting is great for tracking how much of this money is paid and what is outstanding. Every time a claim is paid, the service provider is closer to balancing their sheets and generating the targeted profits needed to keep their business afloat.
Support Compliance
Healthcare providers are subject to several regulatory requirements, especially regarding billing practices and transparency. There are federal laws that these institutions are expected to follow to maintain uniform legal structures. Some of these include the HIPAA (Health Insurance Portability and Accountability Act) and the False Claims Act. Payment posting is a process that helps these hospitals comply with these laws and offers transparent billing services to their patients.
Improving Patient Experience and Satisfaction
It is generally expected that patients rely on providers to give them accurate and understandable billing information, also, for better clarity in terms of their insurance companies’ share of the payment. When payment posting is done correctly, the patient’s statement reflects only what they truly owe, reducing confusion and the likelihood of disputes. Clear and transparent billing is a great way to improve satisfaction and experience all around, because it builds patient trust and minimizes complaints or billing-related dissatisfaction.
Medical Payment Posting Assistance
Payment posting should always be a priority in your business. Evaluate your staff skills to be sure you have the expertise to handle this process. Some health care institutions also get assistance from specialists in billing services. Regardless of the route you choose to take, the priority is to ensure that you’re investing in the right skills to get your desired results, improve cash flow, satisfy customers and improve overall performance.
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