When you hear the term ‘revenue cycle management’ what comes to mind? What is the activity that pops into your head? For many, it is the process of coding. For others, it is denial management.

Rarely payment posting comes to mind even though it is a major function affecting the revenue cycle. Inefficient posting can be a cause of extended days in A/R – creating frustration for your clients. High labor costs with this department can cut into your profitability. According to the 2018 CAQH Index, “remittance advice is the only transaction tracked for which adoption of the electronic transaction declined in the medical industry…use of manual process…increased slightly.” So, what is involved in this counter-intuitive trend?

Although the Index does not give us the cause, the answer may be found in the nature of the transaction. Many smaller payers still rely on sending checks with EOBs that must be posted manually. And, with ERAs there are manual elements to posting as well – such as downloading files, making adjustments for line items, and accounting for reimbursement claw-backs after previous payment.

Healthcare providers in the US reported that processing ERAs required on average three minutes while manual transactions needed seven. As we all know in RCM time means money, and those minutes can add up – contributing to high labor costs while delaying payment posting.

If you have not done so recently, examining how you process payment transactions may reveal opportunities to decrease labor costs and improve days in A/R.

Strategies to create efficient payment posting:

  • Audit how you are receiving payments and convert all payments to ERAs and EFTs whenever possible to take advantage of the time savings
  • Confirm that your staff is well-trained in how to deal with adjustments to ERAs during processing, so time-consuming corrections are not needed
  • Watch analytics for signs that payment posting is being delayed – for example, if days to claim submission is steady, but days in A/R is growing, it may be a sign of troubles with posting
  • Audit bank account deposits against ERA dates to see if there is a lag in posting
  • Consider outsourcing payment posting if you are not doing so already – you can save on labor costs and increase efficiency

With more and more emphasis being placed on the effectiveness of revenue cycle processes because of changing payment models, using time and resources wisely when posting payments can give you a distinct competitive advantage.

Don’t overlook the opportunity that payment posting provides to reduce days in A/R, increase your client satisfaction and reduce labor costs.


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