Best Practices for Payment Posters

As a payment poster, your top priority is to post payments promptly. This ensures that claims can either be closed or returned to the payer for reprocessing. Additionally, it's important to accurately label claims in the RCM so that the billing collections team can effectively follow up on any reimbursement issues with the payer. Prioritizing payment posting is essential to prevent team members from having to call about the status of claims and spending unnecessary time on the phone.

Audience

• Payment Posters are responsible for posting payments in a timely manner, closing claims that are paid according to the expected rate, and assigning claims back to the Billing Collections team for triage.
• Billing Collection Specialists will take over triage once the payment has been posted and sent back to the payer queue for follow-up.

Process Overview

Role	Daily	Weekly
Payment Posters	Post Manual Payments Post Paper Checks/EOBs Import Payment information via EDI Review Electronic Payments Match Payments in Review Verify Payments received	Resolve Inaccurate Data Review Insurance Payment Collections Review Insurance Claims Out of Balance

Payment Posters Daily Tasks

Let's review a payment poster's daily tasks together!

• Task	Steps	Helpful Hints
  Post Payments Received	Go to Work Center > Insurance Payments > Enter Insurance Payment Collections. Select the organization. Click Create Payment Collection Follow the Manual Payment Process outlined here.	Shortcut: Use Work Center Home > Upload Documents to upload an EOB file that creates the shell of the check for you. Create all the checks you’ll be posting, then go back in to post the payment details. Posting these payments to claims will automatically put them in the Payment Review queue for your next step.
  Import EDI Information	Go to Work Center > Insurance Payments > Enter Insurance Payment Collections. Select the organization. Click Create Payment Collection Follow the Import EDI Process outlined here.
  Update Claim Workflow	Click Edit Claim Workflow within the payment. Update the Queue Update the Status Add an Issue (optional) Assign a user (optional) Update the follow-up date	Set up your queues so it’s easy for payment posters to find where to send a claim i.e. “Closed” for closing claims or “Payer” for troubleshooting reimbursement issues.
  Close the Claim (Situational)	Click Close Claim Instance	Only close the claim if the payment meets the expected rate. Otherwise, the claim should be sent back to the Payer queue for Billing Collections to troubleshoot the reimbursement with the payer. You can also close claims from the Workflow tab or the patient’s Claims tab.
  Repeat for each claim that has received payments in the Work Center

• Task	Steps	Helpful Hints
  Match Payments in Review	Go to Work Center > Insurance Payments > Review Insurance Payments Resolve all payments in this list.	Matching ERA payments first ensures that there is no double posting from the payments you will post manually. Don’t worry about closing these claims or triaging them now. The claims will automatically be placed in the Payment Review queue for follow-up on the next business day. Adding a payment note while in the Resolve screen will show on the claim page when “Payment Notes” is checkmarked.
  Verify Payments Received	Go to Work Center > Insurance Claims > Work Claims Filter to “Payment Review” Queue Expand payers Open each claim in a new tab Review the payment note Go to Payments View the EOB Click on the Check number to see how the payment applied.	It may be helpful to review previous notes to get an idea of the claim’s history before adjudication. Use the Claim and Service Totals table at the top of the claim page to quickly see if there is a balance on the claim. If the Balance (Difference Covered vs Expected) is not zero, the reimbursement might not meet the expected rate. Compare the reimbursement to similar claim reimbursements to ensure claims are paid similarly.
  Update Claim Workflow	Click Edit Claim Workflow within the payment. Update the Queue Update the Status Add an Issue (optional) Assign a user (optional) Update the follow-up date	Set up your queues so it’s easy for payment posters to find where to send a claim i.e. “Closed” for closing claims or “Payer” for troubleshooting reimbursement issues.
  Close the Claim (Situational)	Click Close Claim Instance	Only close the claim if the payment meets the expected rate. Otherwise, the claim should be sent back to the Payer queue for Billing Collections to troubleshoot the reimbursement with the payer. You can also close claims from the Workflow tab or the patient’s Claims tab.

Payment Posters Weekly Tasks

Let's review a payment poster's weekly tasks together!

• Task	Steps	Helpful Hints
  Review Insurance Payment Collections	Go to Work Center > Insurance Payments > Review Insurance Payments Resolve all payments in this list
  Review Insurance Claims Out of Balance	Go to Work Center > Insurance Payments > Insurance Claims Out of Balance Open up each claim’s “Resolve” in a new tab Review the list of payments for that claim	Ensuring accurate and complete payment posting is key to the claim’s lifecycle. Reviewing claims out of balance reduces the chance for a surprise recoup or possible refund. Use Apply Reversal to adjust the remittance that was reversed and reimbursed again. Watch out for remits with both PI and OA reversals; those amounts don’t cancel each other out and one code will need to be updated to reflect the true balance.
  Add a Note to the Claim	Click the Notes tab on the Work Claim screen.	It’s worthwhile to add a note to the claim any time you make a change to the claim, including adjusting payments received or applying reversals on the claim.
  Update Claim Workflow	Click the Workflow tab on the Work Claim screen. Update the Queue Update the Status Add an Issue (optional) Assign a user (optional) Update the follow-up date	See Best Practices for Updating Claim Workflow. Set up your queues so it’s easy for payment posters to find where to send a claim i.e. “Closed” for closing claims or “Payer” for troubleshooting reimbursement issues.
  Close the Claim (Situational)	Click Close Claim Instance	Only close the claim if the payment meets the expected rate. Otherwise, the claim should be sent back to the Payer queue for Billing Collections to troubleshoot the reimbursement with the payer. You can also close claims from the Workflow tab or the patient’s Claims tab.
  Repeat for each claim that has received payments in the Work Center