Accurate and timely payment posting is critical to the success of any healthcare provider’s business. In theory a simple process, payment posting is made more complex because it requires us to collate and compare information from diverse sources such as EOBs and denials from payers (the insurance companies), and checks from patients. Gaps in posting can easily result in reduced income and poor patient satisfaction. A thorough understanding of reimbursement contracts, payer guidelines and reasons for claim denials is necessary for successful revenue collection.
NDS can manage this entire process for you. Not only do we take away the headaches, we also deliver superior performance across many parameters such as higher accuracy, productivity and significant reduction in denials.
Challenges faced by a typical US healthcare provider
- Inability to match explanation of benefits (EOBs) with payments and submitted claims leads to lost revenue or delayed receipts.
- EOB terminology is complex and varied; exceptions, denials and multiple payers complicate procedures.
- Inaccuracy of payment posting results in incorrect patient statements and poor patient satisfaction.
- Excessive unallocated payments may be left unresearched, with credit balances on accounts.
- Incorrect denial and adjustment posting results in lost revenue.
What NDS does to enhance efficiency and effectiveness of payment posting.
- Automation and standardization: We obtain copies of all patient and insurance checks and EOBs as well as notifications of direct-deposited funds. We post payments in the billing system, providing instant access to exceptions, for payment recovery and faster processing.
- Electronic Remittance Advice (ERA) management: We download ERAs and/or access them from payer websites, then use them to match deposited funds with remittance advices and ensure that payments are posted. ERA makes reconciliation of payments and denials with claims easier.
- Create allowable fee schedules: We set up fee schedules segmented by payer to track the correctness of all denial and adjustment postings.
- Analytics: NDS furnishes analytical data on denials, EOB and payer issues as well as adjustments (including non-contractual adjustments trend over six months), posting analysis and trended posting cash reports.
- Denial management tools: We provide a toolkit for denial management reporting that makes it easier for providers to track denials and follow them up as needed.
For details about other parts of this service, follow the links below:
How NDS can benefit your business performance through its payment posting service
- Improved staff productivity: ERA management boosts staff productivity by up to 70%
- Accuracy: About 99% accuracy; regular quality assurance measures to realize continuous improvement
- Improved denial management: Automation and use of codes and electronic formats facilitate follow-up and denial reporting
- No backlogs: Unposted cash and posting backlogs are eliminated by the end of each month
- Lower cost: About 30% reduced cost of staffing and training
- Tracking tools: Compare expected vs. actual payments
- Trended denial reports
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