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.

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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.

Lower administrative load

Lower Administrative Load

Reduce repetitive remittance entry tasks for internal staff

Improved posting accuracy

Improved Posting Accuracy

Dedicated payment posting specialists focused on payment integrity

Reduced revenue leakage

Reduced Revenue Leakage

Identify missed adjustments, underpayments and posting errors before they impact collections

Faster reconciliation

Faster Reconciliation

Maintain defined turnaround times for ERA, EOB and complex reconciliation workflows

Clearer financial reporting

Clearer Financial Reporting

Give finance teams more reliable A/R visibility

Lower staffing burden

Lower Staffing Burden

Reduce hiring, training and coverage challenges

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.

Get Started With Your Free Audit

Frequently Asked Questions

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Yes. We support payment posting workflows across Medicare, Medicaid and commercial payers while adapting to payer-specific rules, reimbursement structures, and adjustment requirements.

Content Manager | Medical Billing & Revenue Cycle Management

Written by Junaid Ahmed, Content Manager, Revix MD

Saqib Hassan Vice President at Revix MD.

Reviewed by Saqib Hassan, CEO, Revix MD

Last Updated 

21 September 2026