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Healthcare Payment Posting Explained: EOBs, ERAs, Denials, and KPIs
EPISODE SUMMARY
Jeremy introduces the fourth billing domain, Payment Posting, and explains why it must follow eligibility and benefits. He defines posting as the reconciliation of your expectations (contracts and CPT codes) versus reality (what the payer actually sends). The episode covers the four macro-moves of the territory: Receipt, Posting, Denial Capture, and KPIs. You'll learn the difference between paper EOBs and electronic ERAs, the dangers of "bucket posting," and why a zero-dollar payment is one of the most important transactions you’ll ever document.
KEYWORDS
EOB, CARC, ERA, Payment Posting, Private Practice, Insurance Billing, Medical Billing, Eligibility and Benefits, Insurance Denials, Claim Denials
TAKEAWAYS
Move Beyond "Monopoly Money": Don't just high-five when money hits the bank. Without meticulous posting, you might only be collecting 60-85% of what you're actually owed.
Line-Item Posting is King: Avoid "bucket posting" (lump sums). Matching payments to specific dates of service and CPT codes ensures clean data and prevents missed appeal opportunities.
Zero Dollars is Still a Transaction: When a payer sends a $0.00 remittance, it’s not an invitation to move on. It’s a signal to document the specific CARC (Claim Adjustment Reason Code) to prevent the "tangled ball of yarn" that is unresolved A/R.
Watch Your KPIs: Aim for a Net Collection Rate of 95% or higher and a First Pass Denial Rate of less than 5%. If your days-to-post exceeds two weeks, your financial reports are essentially a lie.
CHAPTERS
00:00 Introduction: Setting the Stage for Payment Posting
05:17 Payment Posting Defined: The Scoreboard of Billing
07:38 The Four Moves That Make Payment Posting Work
11:32 The Payment Posting Workflow: Intake to Line Items
15:47 The Payment Posting Workflow: Denial Documentation
19:38 The Payment Posting Workflow: KPIs
22:10 Case Study: Recovering $78,000 in Lost Receivables
24:24 Conclusion: Mastering the Payment Posting Game
RESOURCES
Today Sponsors: Blueprint
Learn More About The Claim Game: Visit practicesol.com/podcast
The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.
Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.
Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.
Get full access to The Claim Game at jeremyzug.substack.com/subscribe
View all episodes
By Jeremy and Kathryn ZugEPISODE SUMMARY
Jeremy introduces the fourth billing domain, Payment Posting, and explains why it must follow eligibility and benefits. He defines posting as the reconciliation of your expectations (contracts and CPT codes) versus reality (what the payer actually sends). The episode covers the four macro-moves of the territory: Receipt, Posting, Denial Capture, and KPIs. You'll learn the difference between paper EOBs and electronic ERAs, the dangers of "bucket posting," and why a zero-dollar payment is one of the most important transactions you’ll ever document.
KEYWORDS
EOB, CARC, ERA, Payment Posting, Private Practice, Insurance Billing, Medical Billing, Eligibility and Benefits, Insurance Denials, Claim Denials
TAKEAWAYS
Move Beyond "Monopoly Money": Don't just high-five when money hits the bank. Without meticulous posting, you might only be collecting 60-85% of what you're actually owed.
Line-Item Posting is King: Avoid "bucket posting" (lump sums). Matching payments to specific dates of service and CPT codes ensures clean data and prevents missed appeal opportunities.
Zero Dollars is Still a Transaction: When a payer sends a $0.00 remittance, it’s not an invitation to move on. It’s a signal to document the specific CARC (Claim Adjustment Reason Code) to prevent the "tangled ball of yarn" that is unresolved A/R.
Watch Your KPIs: Aim for a Net Collection Rate of 95% or higher and a First Pass Denial Rate of less than 5%. If your days-to-post exceeds two weeks, your financial reports are essentially a lie.
CHAPTERS
00:00 Introduction: Setting the Stage for Payment Posting
05:17 Payment Posting Defined: The Scoreboard of Billing
07:38 The Four Moves That Make Payment Posting Work
11:32 The Payment Posting Workflow: Intake to Line Items
15:47 The Payment Posting Workflow: Denial Documentation
19:38 The Payment Posting Workflow: KPIs
22:10 Case Study: Recovering $78,000 in Lost Receivables
24:24 Conclusion: Mastering the Payment Posting Game
RESOURCES
Today Sponsors: Blueprint
Learn More About The Claim Game: Visit practicesol.com/podcast
The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.
Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.
Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.
Get full access to The Claim Game at jeremyzug.substack.com/subscribe