Payment Posting Services
ERA and EOB posting with adjustments reviewed against your contract, not accepted on trust.
Payment posting is usually treated as data entry, and that is exactly why money leaks through it. Every remittance carries three decisions: what was paid, what was written off as contractual, and what moves to the patient. Post those wrong and your A/R, your write-offs and your patient statements are all wrong together.
The write-off is where the risk sits. A contractual adjustment is the difference between your charge and the rate your contract entitles you to. If the payer pays below the contracted rate and the balance is written off as contractual anyway, the underpayment disappears permanently and silently.
We post daily against your actual fee schedule, so an underpayment is flagged as a variance to appeal rather than absorbed as an adjustment.
The problem
Where this usually goes wrong
Underpayments written off as contractual
A payer pays less than the contracted rate. If posting matches the remittance rather than the contract, the shortfall becomes a write-off and nobody ever sees it. It is the quietest revenue loss in the cycle.
Denials buried inside remittances
A remittance is not only payments. Line-level denials and zero-pay adjudications arrive in the same file. If posting is treated as data entry, those lines are posted and never routed to anyone who works them.
Patient balances that are wrong
Patient responsibility is calculated at posting. Get the coordination of benefits or the adjustment wrong and you bill a patient for money they do not owe, which costs you the balance and the relationship.
What is included
- Daily ERA posting, with manual EOB posting where no ERA exists
- Line-level posting so each CPT is reconciled individually
- Contractual adjustments validated against your loaded fee schedules
- Underpayment variance flagged and routed for appeal
- Denials and zero-pay lines split out to the denial queue automatically
- Patient responsibility calculated after coordination of benefits
- Credit balances and overpayments identified for refund or recoupment
- Daily reconciliation of posted payments against bank deposits
How it runs
Our process
- 1
Post daily
Remittances are posted every business day. Posting lag makes your A/R report wrong, and decisions made on a wrong A/R report are wrong too.
- 2
Reconcile line by line
Each service line is posted individually rather than as a lump payment against the claim, which is the only way a partial payment or a single denied line is visible.
- 3
Check the contract
The allowed amount is compared with your contracted rate for that code and payer. Anything short of the contracted rate is a variance, not an adjustment.
- 4
Route the exceptions
Underpayments go to appeal. Denials go to the denial queue. Credit balances go to refund review. Each leaves posting with an owner rather than sitting in a report.
- 5
Balance to the bank
Posted totals are reconciled against deposits daily, so a missing remittance or a misapplied payment is caught in a day rather than at month end.
Posting as data entry compared with posting as a control
| Metric | Billing in house | With AsesorMD |
|---|---|---|
| Posting frequency | Weekly or in batches | Every business day |
| Adjustment handling | Whatever the remittance says | Validated against your fee schedule |
| Underpayments | Written off silently | Flagged as variance and appealed |
| Denials in the remittance | Posted and forgotten | Split out to the denial queue |
| Bank reconciliation | At month end, if at all | Daily |
Questions we get asked
What is the difference between a contractual adjustment and an underpayment?
A contractual adjustment is the legitimate difference between your charge and your contracted rate. An underpayment is the payer paying below that contracted rate. They look identical on a remittance, and telling them apart means comparing against the fee schedule rather than trusting the file.
How do you know what we are contracted to be paid?
We load your payer fee schedules during onboarding. Without them, underpayment detection is guesswork, which is why practices without loaded schedules generally never find underpayments at all.
Do you post electronically or manually?
Electronically wherever an ERA exists, which is most of the volume. Paper EOBs are posted manually, at line level, to the same standard.
What happens to credit balances?
They are identified and routed for review. Credit balances are not free money. Overpayments from government payers carry a refund obligation with a deadline attached.
How fast are payments posted?
Within one business day of the remittance arriving. Your A/R aging is only as accurate as your posting, and stale posting makes every downstream number unreliable.
Can we buy posting on its own?
Yes. It is a common place to start, because it is labour-heavy, easy to fall behind on, and the one step where underpayments can be caught.
See what your practice is leaving on the table.
We look at 90 days of your claims data and tell you what is recoverable. No cost, no obligation, BAA signed before anything changes hands.
- Recoverable dollars in your aged A/R, as a number
- Denials grouped by root cause, ranked by value
- A written summary you keep either way
Prefer to talk? (301) 786-0552
Or email info@asesormd.com