Payment posting
Payment posting records what a payer or patient actually paid against the claim, and reconciles it against what was expected under the contracted fee schedule.
Follows rejection management. Feeds into denial management and appeals.
Where practices lose money here
Underpayments go unnoticed
Without checking a posted payment against the contracted rate, an underpayment looks identical to a correctly paid claim on the surface, and the difference is never recovered.
Posting lags create a false AR picture
Payments sitting unposted make the AR report inaccurate, which means follow-up staff are working stale numbers and wasting effort on claims that are actually paid.
How we handle it
Auto-post electronic remittance advice (ERA) daily as it arrives from the clearinghouse.
Manually post explanation of benefits (EOB) for payers that still issue paper remittance.
Apply adjustment and write-off codes consistently, matched to actual contract terms rather than defaulted.
Transfer patient responsibility accurately after the payer’s portion is posted.
Reconcile posted totals against bank deposits daily so nothing is posted that was not actually received.
Compare posted payments against the contracted fee schedule to flag underpayments for follow-up.
What you receive
Concrete output for this step, delivered on a set schedule rather than on request.
- A daily posting reconciliation against bank deposits.
- An underpayment report flagged against the fee schedule.
Where this sits in the cycle
Payment posting is where the claim cycle produces a result. It also feeds directly into AR follow-up and denial management, since anything not fully paid needs to move into one of those queues immediately.
Questions about this step
How do you catch an underpayment?
Every posted payment is checked against the contracted allowed amount for that payer and code. A gap gets flagged and routed to follow-up rather than accepted as final.
How current is the posting?
ERAs post daily as received. Paper EOBs are posted within one business day of receipt.
Want us to review how this is handled in your practice right now?
The free billing audit looks at payment posting alongside the rest of the cycle, and comes back with specific findings.