What we do / Payment postingINCLUDED

Every payment matched to the visit it pays

Software reads electronic remittances and matches each payment and adjustment to its visit. Your billing team works what does not match, and nothing is written off to make it fit.

Who does what

Who does what with payments

Software, checked by your billing team

Software

  • Matches payments to visits.
  • Flags payments that differ from what the payer allowed before, take-backs and credit balances.

Your billing team

Your billing team

  • Posts paper checks and explanations of benefits (EOBs) when you send them.
  • Works payments that do not match, and take-backs, with the insurance company.
  • Tells you in writing if an insurance company overpaid you.

You

You

  • Forward paper checks and EOBs.
  • Approve refunds.
Client dashboardSample clinic · Physical therapy · 2 locations
SAMPLE DATAFictional clinic. Synthetic numbers.Updated Mon Sep 28, 6:00 pm

Payments, Sep 1 to 28

Sample clinic

Sample view with synthetic data. The client dashboard is planned; this shows what it will track.

Every dollar that came in, from whom, and what was adjusted.

Insurers and supplement plans, Sep 1 to 28
Paid byPayments receivedClaims paidAmount
Medicare Part B8132$9,459.89
Medicare Advantage A426$1,912.70
Medicare Advantage B425$1,398.00
Commercial PPO A495$8,267.37
Commercial PPO B477$4,604.14
Commercial HMO C445$3,516.48
Payer E (paper checks)1122$3,144.18
Medicare supplement plans792$1,715.92
Insurance total46514$34,018.68

Medicare sequestration (CARC 253): $193.06 on the 132 Medicare Part B claims paid Sep 1 to 28, 2% of Medicare's payment. It is a payer adjustment, not a write-off.

Patients, Sep 1 to 28
Patient paymentsCountAmount
Copays at the visit131$4,555.00
Statement balances94$3,498.49
Patient total225$8,053.49

Total collected Sep 1 to 28: $42,072.17 ($34,018.68 + $8,053.49; equals the Overview tile).

Latest 10 insurance payments
DatePaid byMethodReferenceClaimsAmountPosted
Wed Sep 23Medicare Advantage BEFT···33605$308.22Wed Sep 23
Wed Sep 23Payer E (paper checks)Check···63882$324.22Wed Sep 23
Thu Sep 24Medicare Advantage AEFT···93505$307.13Thu Sep 24
Thu Sep 24Medicare supplement plansEFT (crossover)···47497$125.51Thu Sep 24
Thu Sep 24Payer E (paper checks)Check···95882$225.94Thu Sep 24
Fri Sep 25Commercial HMO CEFT···350113$1,116.07Fri Sep 25
Fri Sep 25Medicare Part BEFT···387614$982.00Fri Sep 25
Fri Sep 25Payer E (paper checks)Check···38241$134.81Fri Sep 25
Mon Sep 28Medicare supplement plansEFT (crossover)···147918$291.96Mon Sep 28
Mon Sep 28Payer E (paper checks)Check···84602$290.68Mon Sep 28

References are synthetic 4-digit endings.

Written off this month
AdjustmentAmountDetail
Patient balances written off$887.2819 balances, 15 patients; approved by you at the August review, posted Tue Sep 1
Denials written off after appeal$547.417 claims (visit limit 2, authorization 2, missing information 1, medical necessity 1, coordination of benefits 1): insurer share $512.07, supplement $15.34, patient $20.00
Total written off$1,434.69Equals the September row of the trend table

Recovered this month: 18 claims paid after appeal ($1,497.79); 13 underpaid claims corrected by Commercial PPO B on Sep 22 ($150.41).

FIG. 1Sample payments posted, Sep 1 to 28. Synthetic data. Example: a fictional physical therapy clinic.See every view

What we do

How each payment is posted

  1. Electronic remittances

    Electronic remittances (ERAs) are matched to their visits, payment by payment and adjustment by adjustment.

  2. Paper checks and EOBs

    Paper checks and EOBs are posted when you send them.

  3. Differences from what the payer allowed

    Payments that differ from what the payer allowed before are flagged and worked with the insurance company.

  4. Refunds

    Refunds are prepared by your billing team and approved by you. Software never moves money.

  5. Overpayments

    Overpayments reported to you in writing.

What the rules say

Why posting is worth doing carefully

Manual remittances cost practices more staff time, and money paid by mistake has a legal clock.

  • Provider staff time per remittance: $5.67 when handled manually, $2.95 electronically (2023 data).
    $5.67, $2.95

    Source: CAQH, 2024 (2023 data)1

  • Medicare and Medicaid overpayments must be reported and returned within 60 days of being identified.
    60 days

    Source: HHS OIG, 2023-112

Questions

Questions about payment posting

Yes. Your billing team posts paper checks and explanations of benefits (EOBs) when you send them.

Anything that does not match is flagged, not written off. Your billing team matches each take-back to the claim it came from and works it with the payer.

Next question: what happens to claims that are not paid?

Notes

  1. 1.CAQH, 2024 CAQH Index, p. 51, 2024 (2023 data) (survey).Back to text
  2. 2.HHS OIG, General Compliance Program Guidance, 2023-11 (government guidance).Back to text