Payment Posting
ERA and explanation of benefits (EOB) payments posted line by line, matched to contracts and bank deposits — with denials and underpayments routed for action, never written off silently.
Payment posting is the moment billing becomes accounting truth. Every decision the payer made — paid, adjusted, denied, applied to the patient — enters your books here, and every error made here corrupts everything downstream: AR reports, patient statements, underpayment detection. Elite Bill Care's payment posting service posts ERA and EOB remittances accurately, reconciles them against actual deposits, and routes every exception to the workflow that owns it.
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What accurate posting includes
- ERA (835) posting — electronic remittances auto-posted through your system, then reviewed line by line rather than trusted blindly.
- Manual EOB posting — paper and portal remittances keyed accurately for payers that still do not send ERAs. Each paper EOB is reconciled against the ERA/835 feed for the same payer and payment so nothing posts twice or goes missing.
- Contractual adjustments — written off strictly per the payer's contract for that code and modifier, never by habit or round numbers.
- Denial routing — every denied line leaves posting with a task attached in denial management, not just a zero balance.
- Patient-responsibility transfer — deductible (PR-1), coinsurance (PR-2) and copay amounts moved to patient balances accurately for patient billing.
- Deposit reconciliation — posted totals matched to EFT deposits and checks, so what the payer reported and what the bank received are proven equal.
- Recoupment and offset handling — payer take-backs and forward balances recorded transparently, never netted silently into other payments.
Why posting errors are so expensive
Posting is a quiet job with loud consequences. A denial posted as a contractual adjustment disappears from every work queue — revenue written off by a keystroke. An underpayment posted without comparison to the contract teaches the payer that the lower rate is acceptable. Patient balances transferred late become statements sent months after the visit, when collection is hardest. And unreconciled remittances mean the practice cannot say, on any given day, what it was actually paid. Accurate posting is what makes our reporting — and your decisions — worth anything.
Underpayments: found here, or never found
Payers do not always pay the contracted rate, and they rarely announce the difference. Posting is the one place every paid line passes through human (or systematic) review against the contract. Our posting workflow compares allowed amounts to your fee schedules and flags variances instead of absorbing them — the flagged lines then work through AR follow-up until the payer corrects them or documents why the rate applied.
How posting fits the cycle
Claims go out through electronic submission; money and decisions come back to posting. From posting, paid claims close, denied claims route to appeals, patient amounts route to statements, and the whole picture rolls up into revenue cycle reporting. It is the hinge of the system described on our medical billing services page — and the step practices most often under-staff.
Frequently asked questions
What is the difference between ERA and EOB posting?
The information is the same; the format differs. An ERA (835) is the electronic remittance file that posts largely automatically through your clearinghouse and practice-management system. An EOB is the paper or PDF explanation that must be posted manually. We post both — and reconcile both against actual deposits, because an ERA records what the payer says it paid, which is not always what arrived.
What are contractual adjustments, and why do they matter?
The difference between your billed charge and the payer's contracted allowed amount, which you have agreed not to collect. Posting them correctly per contract keeps your AR honest. Adjustments posted carelessly are a classic hiding place for real losses — underpayments and even denials written off as 'contractual' and never questioned.
How do you catch underpayments?
Each remittance line is compared with the contracted rate for that payer, code and modifier. Lines paid below contract are flagged into a variance queue for follow-up rather than adjusted away — see how this connects to AR management.
What happens to patient-responsibility amounts during posting?
Deductibles, coinsurance and copays identified on the remittance (PR group codes) are transferred accurately to the patient balance at posting time, so patient billing starts from correct numbers and statements go out promptly.
Do you reconcile posting with bank deposits?
Yes — that is the point of the EFT and ERA pairing. Posted amounts are matched to deposits so missing payments, partial deposits and payer recoupments are found within the cycle, not at year-end.
Make your books match your bank
Start with a free consultation: tell us your payers and systems, and we will show you how posting and reconciliation would run for your practice.