Service Spotlight: Payment Posting and Denials Management

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

Getting your reimbursement from payors is key to any successful practice. However, ensuring those payments are posted accurately and denials are worked promptly, can not only make a huge difference in your cash flow, but your practice’s overall financial health.

Why is timely payment posting so important? When payments are posted within 24-48 hours of receipt, it ensures your Accounts Receivable (AR) and Days Sales Outstanding (DSO) is accurate. This is pivotal to the overall revenue cycle of a practice to be able to gauge not only incoming funds, but potential reimbursement from claims that are still pending payment.

Accurate posting is also critical. If payments are not applied correctly, balances may be adjusted off completely or transferred to the patient. If the balance is adjusted off completely, unless your RCM Manager is running an adjustments report regularly, there is an opportunity for lost cash. If the balances are dropped to the patient, your office is going to be flooded with upset patient calls about incorrect balances they owe.

Additionally, posting zero pay remits is critical to tracking your denials. Your system should be set up to include Claim Adjustment Reason Codes or CARC codes. These codes help identify denial reasons, copays, deductibles, and co-insurances. It is key that you ensure every denial is accounted for to ensure maximum reimbursement for your practice.

This leads to denials management. Tracking your practice’s denials will help you identify gaps in the front end or back end process. Likewise, ensuring that all denials are worked withing three to five business days of receipt will reduce timely filing issues and keep cash coming in the door.

Legacy Consulting Services can handle all aspects of the Revenue Cycle for your practice, including accurate and timely payment posting and denials management. Contact us today for more information on how we can help your office.

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