Your Payment Posting Agent Posts the ERA and Flags the Short Payments
The AgentWorks Payment Posting Agent takes the keying out of payment posting. It processes ERA files as they arrive, posts each payment to the correct patient account, compares what the payer paid against your contracted rate, and produces a daily reconciliation report, so your billing team spends its time on the claims and patient questions that need a person.
What it takes off your plate
In most practices, payment posting is data entry. The ERA files arrive from the clearinghouse and someone works through them line by line. Paper EOBs arrive in the mail and get keyed by hand. Adjustments, denials and patient responsibility all have to land in the right place on the right account.
Nobody has time to check the payment against the contract. The payer allowed a little less than your fee schedule on a common procedure code, and the short payment gets posted like any other. It happens again the next week, and the week after. The cost is revenue the practice earned and never collected, patient balances that are wrong when the patient calls, and a billing team that is always a few days behind the deposits.
What the Payment Posting Agent does, step by step
The Payment Posting Agent starts where the money and the questions come in.
- It answers the balance question. When a patient calls or messages about a statement, it confirms what insurance paid on the visit and what the patient owes, from the posted record, and routes disputes to your billing staff.
- It chases what is missing. When a payment appears on the deposit without a matching ERA, or an EOB has not arrived, it contacts the payer or the clearinghouse for the remittance and logs each request.
- It reads the remittance. It processes each ERA file as it arrives and reads scanned paper EOBs, pulling the claim, the allowed amount, the paid amount, adjustments and patient responsibility for every line.
- It posts to the account. It posts each payment and adjustment to the correct patient account and claim in the practice management system, such as Athenahealth or Kareo, and moves patient responsibility to the patient balance.
- It checks the contract. It compares each paid line against the contracted rate for that payer and code. Where the payment falls short, it flags the line for your billing lead with the contract rate, the paid amount and the payer. It does not file an appeal; your staff decide what to pursue.
- It reconciles the day. It matches posted payments to the bank deposit and writes a daily reconciliation report listing anything that did not match.
Where the work is recorded
Every payment, adjustment and flag lives in the practice management system your billers already use, on the patient account and the claim. When a patient calls about a statement, anyone at the front desk can see what the payer paid and why the patient balance is what it is. Every call and message about a balance is logged on the patient's record as well.
The underpayment flags sit in a work queue with the payer, the code and the difference, ready for follow-up. The next morning your billing lead opens the reconciliation report and sees yesterday's deposits matched to postings, the lines that did not match, and the short payments by payer. Over time, the Payment Posting Agent shows which payers underpay which codes, which is exactly what you want in hand at contract renewal.
When a flagged claim becomes a denial, our post on working every appeal on denied claims picks up the story.
What your people do instead
Your billers stop keying EOBs and start working the money: appealing the underpayments worth pursuing, calling payers about claims that have stalled and explaining statements to patients who are confused by them. That conversation with a worried patient about a bill is human work, and it goes better when the balance on the screen is right.
Your practice manager gets a revenue picture that is current every morning instead of a few days behind. Providers and clinical staff stay with patients, knowing the practice is collecting what its contracts say it should. For the authorization work that comes before the claim, see how chasing every prior authorization daily gets patients into treatment sooner.
One next step
If your posting backlog is hiding short payments, take the free Healthcare Industry Assessment. It shows which workflow an agent should take first. To see every agent built for medical practices, visit the AgentWorks healthcare page.
See where the Payment Posting Agent would start in your healthcare business.
I'm Dr. Mitchell, the Healthcare ambassador here. The free Industry Assessment reads your website and asks how calls, follow-ups and records happen today, then shows the first workflow worth handing to an agent like this one — and what your team gets back. Leave your email and I'll send the link.
Dr. Mitchell replies from healthcare@agentworksstudio.com. One email with the link — no list, no drip, unless you ask for the weekly letter. Or go straight there →