•Post decision and payment information automatically, for individual claims included in an RA to the appropriate beneficiary accounts when a compatible provider accounts receivable software application is being used;
•Identify the reasons for any adjustments (denials or payment reductions);
•Note when an EFT payment issued with the ERA is scheduled for deposit in the provider’s bank account, or arrange for a deposit of a paper check being issued;
•Submit a secondary electronic claim that incorporates Medicare adjustment and payment data from the ERA to other health care plans that cover the beneficiary if the ERA does not indicate that Medicare has issued a Coordination of Benefits (COB) transaction;
•Submit a paper secondary claim when appropriate to other health care plans to which is attached a print-out of the Medicare ERA information for that claim;
•Print for specific payment information, as needed, by using translation software [e.g., PC-Print for institutional providers and Medicare Remit Easy Print (MREP) for professional providers and suppliers];
•Use it to quickly identify potential problems with the way the original claim was submitted, so as to avoid the same errors with similar claims in the future.
When an SPR (Paper EOB) is received, providers may:
•Post manually to accounts receivable;
•Use it to correct any errors that may have been encountered during claims processing;
•Bill secondary health care plans that cover the beneficiary.
Example EOB and payment posting
In the line item field, choose the right patient and correct DOS and CPT. Enter the paid amount , patient responsibility amount in the respective field. For Example in the above EOB, For CPT 99205, paid amount is $74.51 and the patient responsibility is $128.42 ( Choose the correct reason for patient responsibility. Most of the software would calculate the write off adjustment automatically. Post payment for all CPT and all patient in the EOB one by one in the same receipt. Check amount and software paid amount has to be equal otherwise we did some mistake in the process. In the software payment posting would be like the below image.
This is how we have to post the payment in the software.
Payment posting process
How to post payment