Access Payment Reconciliation leverages EFT Reassociation to ERA matching technologies to link remittance advices to payments via a reference identifier (TRN). By matching the transaction number systematically, a list of outstanding payments is generated and easily managed. The HHS standard identifies the EFT transaction as a HIPAA transaction, and requiring Payers to provide the payment as an EFT via the ACH Network if requested by the Provider.
Reconciliation is challenging due to the complications of balancing transactions from a variety of sources. Reconcilers need to review transactions from the HIS/PM system as well as log into the bank deposit account. Many still utilize spreadsheets to track this process.
Even if providers have converted to 80 or 90 percent electronic remittances and payments, reconciliation can become a challenging exercise to reconcile the following scenarios:
- Electronic claims (837) to electronic remittances (835) and EFT payments (ACH)
- Electronic claims (837) to electronic remittances (835) and paper payments (check-only)
- Electronic claims (837) to paper remittances (EOB) and paper payments (check)
- Electronic claims (837) to paper remittances (EOB) and EFT payments (ACH)
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- Reduces reconciliation time and reduces labor via automated matching and reporting
- Identifies errors and misbalanced payments
- Improves research process with archive of transaction data and images
- Provides full payment picture from claim creation, insurance remittance to patient payments
- Reduce receivables, revenue leakage and bad debt
- Reduces suspense account entries
- Ability to close your monthly and quarterly financial reporting faster and more accurately
- Reduction in secondary billing delays
- Reduction in delayed collection of patient self-payments
- More accurate posting of receivables before cash is received (Note: it is a violation of the Sarbanes-Oxley provisions related to accuracy of financial statements)
- Improves denials management
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