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Physical Therapy EMR Payments Posting | Best Practices for A Better Cash Flow

Physical Therapy EMR Payments Posting
Ensuring the financial health of the physical therapy clinic requires payments posting to be done at a regular cadence, among other things. There are several transactions to be pulled together:
  • Outgoing claims and patient statements
  • Incoming EOBs and ERAs from claims sent
  • Funds electronically transferred from payers
  • Copayments received from patients daily
  • Insurance/patient checks arriving by mail
Playing a pivotal role is the Physical Therapy EMR that connects the dots across these disparate streams of transactions to post payments and keep track of them. Adopting payments posting best practices will help stay clear of cash flow problems. Here are some key ones.

Collect Patient Monies Upfront

When it comes to patient payments, it would be a good idea to:
  • Estimate patient benefits upfront, factoring in the patient?s deductible/copays etc.
  • Educate patients on their benefits and charges so that there are no surprises.
  • Collect monies before the EOB/ERA comes back with the exact patient balance.
When patients drop off and EOBs/ERAs are delayed, collecting hundreds of dollars of patient balances can become a challenge.

Post Payments Methodically

The next step is to post payments and allocate payment amounts in the EMR to specific services rendered to the patient. Posting payments adds them into the EMR. Allocating payments applies the posted payment to charges. Posting and allocation could be manual or automated. Payments posting steps include:

Manual EOB Posting

  • Allocate payments to dates of service and charge line items by entering payment amounts.
  • Allocate remaining balances to the secondary payer/patient or write off balances or leave balances in the system for claims follow up.
  • Post selected charges in the system while retaining the possibility of editing postings in the future.

Auto Posting of ERAs

  • Import ERA electronic files into the EMR directly from an integrated clearing house or through a file upload.
  • Review auto-postings and make any changes as needed, for example shifting insurance write off amounts to follow up.
  • Post all payments and transfers, create the checks in the software, and transfer all responsibility.
  • Post patient payments received earlier for whom the ERA transferred responsibility to the patient.

Posting Patient Payments

  • Find any patients that have monies collected in the system that is not posted or allocated yet (to avoid over billing them).
  • Create a patient invoice or patient statement that is sent to patients spelling out what they owe.
  • Post checks received from patients in the EMR and allocate them to existing patient balances or to patient statements that were sent out.

Tracking Everything through Reports

  • Review and audit the process to make sure nothing has slipped through the cracks for partially posted and unposted payments.
  • Discover any remaining balance payments that were not allocated to patient charges including ones where the postings were started but not completed.
  • Avoid posting patient payments before there is a responsibility spelled out in the EOB/ERA to avoid double counting patient responsibility when the EOB/ERA comes back and adds patient amounts.

Reconcile Payments With The Bank

End of the day, the transactions ledgers in the EMR and in the bank account should be in sync. The EMR and its reports should make it easy to ensure that there is a single version of the truth. Steps include:
  • Reconcile what went into the bank account with what was posted in the EMR system.
  • In case of delayed EMR postings, use reports to reconcile ERAs with the bank account and with the earlier funds transfer.
Leveraging payments posting best practices in the EMR helps avoid process inefficiencies and helps keep cash flow humming for a healthier clinic. Additionally, analytics from payment posting shines a light on reimbursement trends and increases clarity on the state of the revenue cycle.