by Plutus Health
ABA Providers, who’s training and time are focused on treating clients, may not be adept in working with Insurances or stay in sync with the evolving methods and technologies of payment posting in medical billing, and can find the whole process utterly or partially confusing and even miss out on key areas and make errors. So, here is a detailed guideline about the role of importance of on-time posting of payment in Revenue Cycle Management (RCM) and a step by step process of payment posting for ABA Providers that help them as well as the clients’ family to function holistically.
Payment Posting is an elementary step in Medical Billing. This is the process of logging or posting the payments and related information in either manual paper EOBs and receipts, or as automated ERA entries in the billing software or practice management systems. The entries should include:
● Payments received from insurance companies and other sources based on Electronic Remittance Advice (ERA), which is an explanation of the claim’s payment provided by the insurance company.
● Insurance coverage and other payment details based on the Explanation of Benefits (EOB),which is an account of things explained to the patient by the payer.
● General information of clients, including patient demographics, account records, payment balances of cost of care etc.
● Unpaid insurance claims, it's current status and other details regarding the claims.
● Track denials- these are statements given by the Insurance Companies denying to honor the request by the provider or patient to pay and why they can't do so. For ABA providers, working with denials is a constant process. There can be soft and hard denials, with soft denials being re-filed, while the hard denials are final. With well-organized and categorized denials tracking, providers can reduce the volume of denials, and avoid the mistakes and errors that may be the common cause of denial.
The Process of Payment Posting requires the collection and uploading of the relevant data, into the software. Among the best practices of ABA payment posting, is to maintain a consistent timekeeping between billing and payroll. Whether you use any billing software, or simply maintain an Excel Sheet, it is recommended that you update the software or management system every day, or at least once a week, to avoid any unforeseen situation when you have to search for valuable information that is needed.
● Keep a copy of all checks and payments made by both clients and insurance companies, in"daily batches" of files or folders. And store them at convenient and secure places, that is also easily accessible when needed.
● Coordinate EOBs with Electronic Fund Transfers (EFT) and keep them together, to have a complete account of payments.
● Avoid delays in depositing the checks, and do it as and how you get them, according to the daily batches. Thus, you can maintain subsequent information for taxes and insurance-related inquiries and audits.
● Have the patient's responsibilities, and payments allocated separately, and concisely while posting the payments
● Merge all checks with a single bank account and a single payment posting interface to make it consistent and transparent for the year-end tax audits to review your accounts.
● Include all miscellaneous documents, such as payment receipts for clients, monthly, weekly or ongoing payments, as well as co-pay amounts into segregated fields. In case you have any co-pay amounts, you can collect them upfront.
Applied Behavior Analysis (ABA) is among the most scientific and documented approaches for Autism Spectrum Disorder. This is administered as a continual therapy. The individualized costs of care for a single patient, including ABA Therapy and additional medical treatments are above $3 Million in the US, that can increase up to $7 Million. Such an amount is largely beyond the capacities of parents and families to afford out-of-pocket, even as a monthly,annual or an ongoing bill.
Therefore, Health Insurances are practical solutions for the cause. And for the reimbursement coverage, ABA providers must administer timely Payment Posting, which is crucial for Medical Billing.
With the emergence of highly skilled Medical Billing companies and technology, ABA Providers can breathe a sigh of relief, for being able to outsource the payment posting and denial tracking that successfully helps Providers reduce claim denials and optimize revenue.
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