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Payment Posting & Reconciliation
Payment Posting & Reconciliation Services
Every missed payment detail can impact your collections. Revix MD’s payment posting and reconciliation services help medical practices maintain accurate financial records through precise payment application, ERA/EOB processing, EFT reconciliation and payment variance review – giving your team a clearer view of what has actually been collected.
Performance Benchmarks
Performance Standards for Payment Posting and Reconciliation Services
See how Revix MD’s payment posting workflow is designed around accuracy, timely reconciliation, and revenue visibility.
Metric
Revix MD Standard
ERA Payment Posting
Same-day processing where electronic remittance is available
EOB / Paper Remittance Posting
Typically completed within 24-48 hours
Complex Reconciliation Review
Typically completed within 48-72 hours
Payment Variance Identification
Reviewed before unresolved balances impact A/R
Our Approach
Revenue Integrity Built Into Every Remittance
Payment posting and reconciliation is the point where payer decisions become financial records. Revix MD manages the complete payment posting lifecycle – from ERA receipt and EFT matching to final reconciliation – so your medical billing team has accurate data for collections, reporting, and follow-up.
01
ERA & EOB Auto-Posting With Exception Review
We process ERA (Electronic Remittance Advice) and EOB (Explanation of Benefits) files through automated X12 835 transaction parsing, matching payments and adjustments directly to the appropriate claims.
Each remittance is reviewed for accuracy before final posting. Exceptions such as unexpected adjustment codes, payment mismatches, denial-related issues, or unusual payer behavior are routed for manual review instead of being posted incorrectly.
02
EFT/ERA Reassociation & Deposit Reconciliation
For payers that send EFT (Electronic Funds Transfer) separately from ERA, Revix MD ensures CAQH CORE-compliant reassociation using EFT trace information to match deposited funds with the corresponding ERA transaction.
Our team reconciles posted payments against actual deposits, reviewing payment variances, missing remittance details, duplicate payments and misapplied EFTs before they create downstream reconciliation issues. We also review PLB (Provider Level Adjustment) segments within 835 transactions to properly handle non-claim-specific adjustments such as interest payments, late fees, capitation adjustments, takebacks and retroactive payer corrections.
03
Denial, Underpayment & Credit Balance Resolution
Payment posting requires more than entering payments – adjustment accuracy directly impacts revenue recovery. Our team reviews CARC and RARC codes during payment processing, including common adjustment scenarios such as:
CO-50
Non-covered services or medical necessity
CO-97
Bundled services and NCCI-related edits
CO-22
Wrong payer or coordination of benefits
CO-29
Timely filing adjustments
CO-151
Frequency limit adjustments
PR-204
Services not covered under patient plan
Underpayments are identified against payer contract expectations, while payer takebacks and recoupments are reviewed carefully to ensure previous payments are adjusted correctly. Unresolved variances feed directly into our denial management workflow for structured appeals. Unresolved credit balances are tracked individually with proper documentation to support compliance requirements.
04
Real-Time Reporting & Posting Audit Trail
Every posted transaction includes a detailed audit trail with payment information, adjustment details, and processing history. Your billing and finance teams receive visibility into reconciliation status without waiting for month-end reporting cycles.
Comprehensive Coverage
What Our Medical Payment Posting Services Include
Revix MD’s medical payment posting services cover the complete posting lifecycle.
Service
What It Covers
ERA Posting
Automated posting directly from clearinghouse ERA feeds
EOB Posting
Manual entry and verification of paper remittances
EFT Posting
Matching electronic deposits with related remittance details
Patient Payment Posting
Accurate application of co-pays, deductibles and patient payments
Contractual Adjustment Posting
Verification against payer fee schedules and contracts
Zero-Pay Claim Review
Identifying true denials versus processing delays
Secondary Claim Triggers
Supporting crossover claim workflows after primary adjudication
Crossover Claim Posting
Medicare and Medicaid coordination workflows
Payment Takeback Review
Proper handling of payer reversals, recoupments and negative adjustments
Software Integration
Seamless System Compatibility Without Platform Disruption
We do not require you to replace your existing technology. Revix MD works within your current billing environment to maintain continuity.
Clearinghouse ERA Feed Connection
We connect with your clearinghouse ERA feeds so remittance information flows directly into the posting workflow instead of requiring manual payer-by-payer downloads.
X12 835 Auto-Posting
Standardized 835 files are processed and matched against claims, adjustments and payment details while identifying exceptions requiring review.
PM/EHR Sync
Posted payment information syncs with your practice management system or EHR, keeping A/R reporting aligned with actual collections.
Exception Routing & Reporting
Any transaction that cannot be automatically posted is reviewed with complete error details, allowing your team to address issues quickly.
Compliance Framework
Payment Posting Compliance & Administrative Standards
HIPAA, Data Security & Access Controls
Revix MD follows HIPAA-compliant workflows designed to protect protected health information (PHI) and sensitive financial transaction data. Payment posting processes include controlled access, secure handling procedures, audit tracking and operational safeguards to support healthcare data privacy requirements.
ASC X12 5010 & Electronic Transaction Standards
Electronic payment workflows follow current X12 835 transaction standards to support accurate remittance processing and payment application.
CMS EFT/ERA Enrollment & CAQH CORE
We align payment workflows with CMS EFT/ERA requirements and CAQH CORE operating rules, including EFT and ERA reassociation processes.
Granular CARC/RARC Review
Adjustment and denial codes are reviewed against standard Claim Adjustment Reason Codes and Remittance Advice Remark Codes before payment changes are finalized.
OIG Credit Balance Compliance
All overpayments and credit balances are documented, flagged, and resolved according to the 60-day overpayment rule under ACA Section 6402(a) and Office of Inspector General expectations to reduce audit exposure.
Outsourcing Advantage
Why Practices Outsource Medical Payment Posting
When practices outsource payment posting, the goal is improving accuracy, reducing administrative workload, and protecting revenue.
Specialized Posting Capabilities for Group Practices and Clinics
Our payment posting services support solo practices, multi-specialty groups, hospitals, and specialty clinics across the U.S.
We process Medicare, Medicaid, and commercial payer payments while adapting workflows to payer-specific rules, contract requirements, and reimbursement structures.
Frequently Asked Questions
What does a medical payment posting service include?
Revix MD’s payment posting services include ERA posting, EOB processing, EFT reconciliation, patient payment posting, contractual adjustment posting, denial adjustment review, payment variance analysis, and reconciliation reporting. Our team helps ensure payments are accurately applied and financial records stay current.
How do you ensure payment posting accuracy?
We use a structured review process that includes X12 835 transaction processing, claim-level payment matching, adjustment code review, payer contract verification, and reconciliation checks. Exceptions such as mismatched payments, incorrect adjustments, or unusual payer activity are reviewed before final posting.
Do you handle EFT and ERA reconciliation?
Yes. When payers send EFT payments separately from ERA, Revix MD uses EFT trace information to match deposited funds with the correct ERA transactions. This supports accurate payment application and CAQH CORE-compliant EFT/ERA reassociation workflows.
How quickly are payments posted?
Electronic ERA payments are typically posted the same day when available. EOB and paper remittances are generally completed within 24-48 hours, while complex reconciliation cases may require additional review depending on payer and transaction complexity.
Can you identify underpayments and incorrect payer adjustments?
Yes. Revix MD reviews payment variances against payer expectations and contracted rates to identify underpayments, incorrect adjustments, missed payments and potential revenue leakage before they impact collections.
How do you handle payer takebacks, recoupments and negative payments?
Payer reversals, takebacks, and recoupments require careful review because they can affect previously posted payments. Our team tracks these adjustments, verifies the reason codes, and ensures account balances accurately reflect payer changes.
Do you review denial adjustment codes during payment posting?
Yes. Our payment posting workflow includes CARC and RARC review to identify adjustment reasons such as non-covered services, bundling edits, timely filing issues, coordination of benefits problems, and benefit limitations.
Will we need to change our current practice management system or EHR?
No. Revix MD works with your existing practice management system, EHR and clearinghouse workflow. Our goal is to improve your payment posting process without disrupting your current operations.
Can Revix MD work alongside your internal billing team?
Yes. Many practices outsource payment posting and reconciliation while keeping other billing functions in-house. We can work as an extension of your existing revenue cycle team.
How does outsourcing payment posting improve revenue cycle performance?
Accurate payment posting gives your practice better A/R visibility, reduces posting errors, helps identify missed revenue opportunities and allows internal teams to focus on higher-value revenue cycle activities.
Can Revix MD support Medicare, Medicaid and commercial payer payments?
Yes. We support payment posting workflows across Medicare, Medicaid and commercial payers while adapting to payer-specific rules, reimbursement structures, and adjustment requirements.
Written by Junaid Ahmed, Content Manager, Revix MD
Reviewed by Saqib Hassan, CEO, Revix MD
Last Updated
21 September 2026