Chatsworth, California
EOB · ERA · Payment Reconciliation

Unposted Payments. Wrong Accounts.
Missed Variances. Your AR Is Silently Wrong.

Payment posting errors don't announce themselves — they accumulate quietly in your AR, inflating aging reports, hiding underpayments, and triggering unnecessary denial follow-up on claims that were already paid. Healthcare Logic processes every EOB and ERA with same-day accuracy, daily bank reconciliation, and automatic variance flagging so your AR reflects reality at all times.

99.2% Payment Posting
Accuracy Rate
Same Day ERA & EOB Posting
Turnaround
Daily Bank Deposit
Reconciliation
$48,230
Posted Today
Remittance Processing Queue
Today's EOB & ERA Activity
Aetna PPO — ERA #8821
47 claims · Posted 9:14 AM
$18,450
Reconciled
BCBS — ERA #4417
12 claims · Variance detected
$6,210
Variance
United Healthcare — ERA #9903
31 claims · Posted 11:02 AM
$14,780
Reconciled
Cigna — EOB Paper
3 claims · Denial reason CO-50
$2,340
Routed AR
Medicare Part B — ERA #1155
22 claims · Processing
$6,800
In Queue
$48,230Posted
$6,210Variance
$6,800Pending
Aetna ERA posted · 47 claims matched
BCBS variance flagged · $420 underpaid

Most Practices Don't Know Their AR Is Wrong — Until It's Very Wrong

Payment posting looks simple from the outside — money comes in, it gets recorded. But the gap between what payers send and what actually gets posted correctly is where significant revenue gets lost, delayed, or permanently written off. The errors are invisible until they compound into a financial problem that takes months to untangle.

Unposted ERAs Leave Paid Claims Open in AR — Indefinitely

When an ERA is received but not processed the same day — a common problem in under-resourced billing departments — the associated claims remain open in AR as if they were never paid. Staff then generate follow-up calls, letters, or appeals on claims that were already adjudicated and paid. This wasted labor costs an average of $8–12 per claim and delays the detection of actual denials sitting in the same backlog.

Payer Underpayments Go Undetected Without Fee Schedule Validation

Payers routinely underpay claims — sometimes by design through incorrect fee schedule application, sometimes through system errors, and sometimes through deliberate reduction of bundled or modifier-bearing claims. Without automated validation of each payment against the contracted fee schedule at the time of posting, these underpayments are simply accepted as correct, posted as full payment, and the variance is permanently lost. MGMA estimates systematic underpayment at 1–3% of total revenue for most practices.

Denial Reason Codes Buried in Remittance Are Never Actioned

Payer denials arrive embedded within remittance files — as CARC and RARC codes on ERAs, or as remark codes on paper EOBs. In practices where payment posting is done manually or by staff unfamiliar with denial code interpretation, these codes are often posted as zero-paid without being flagged for appeal. The denial goes undetected. The clock on the appeal deadline runs. And 30 days later the revenue is beyond appeal window entirely.

Misapplied Contractual Adjustments Distort Net Revenue Reporting

Every payer payment comes with contractual adjustments — the difference between billed charges and the contracted allowed amount. When these adjustments are posted to the wrong account, posted at the wrong amount, or simply not posted, your gross charges, net revenue, and AR aging reports all show incorrect figures. Leadership makes financial decisions — staffing, investment, growth plans — based on revenue data that doesn't reflect the actual financial position of the practice.

Remittance Error Exposure: A Typical 5-Provider Practice
Revenue lost to undetected payer underpayments$78K/yr
Denials missed in remittance beyond appeal deadline$52K/yr
Labor cost working AR on already-paid claims$35K/yr
Contractual adjustment errors distorting net revenue$28K/yr
Estimated Annual Remittance Exposure ~$193K

* Estimates based on MGMA, HFMA, and CAQH benchmarks. Healthcare Logic provides a free AR reconciliation audit to identify posting gaps and underpayment patterns in your current remittance workflow.

Complete Reconciliation & Remittance Processing Services

Healthcare Logic manages the full remittance workflow — from ERA receipt and EOB digitization through payment posting, fee schedule validation, denial capture, and daily bank reconciliation — so your AR is accurate, current, and audit-ready at all times.

01

Same-Day Electronic ERA (835) Processing

We receive and process all incoming electronic 835 ERA transactions the same business day — typically within 4 hours of clearinghouse delivery. Every claim line is matched to the open claim in your practice management system, payments are posted, contractual adjustments are applied, and any denial reason codes are identified and routed for action before end of business.

02

Paper EOB Digitization & Manual Posting

Paper Explanation of Benefits documents — from payers that don't yet send electronic remittance — are received, digitized, indexed by payer and date, and manually posted within 24 hours. We read every CARC, RARC, and remark code on each EOB, categorize the payment type (paid, denied, partial, forwarded to secondary), and route actionable items accordingly. Paper EOBs are stored digitally and accessible for audit purposes.

03

Fee Schedule Validation & Underpayment Detection

Every payer payment is validated against your current contracted fee schedule at the time of posting. When the paid amount falls below the contracted rate — for any CPT code, modifier combination, or payer plan — the variance is flagged, documented, and routed to our AR team for recovery. We track underpayment patterns by payer and CPT code over time, surfacing systematic reimbursement issues that warrant contract-level correction.

04

Denial Detection & Same-Day AR Routing

Denial reason codes embedded in every ERA and EOB are read and categorized at the time of posting — not left as zero-paid records for a later review cycle. Each denial is classified by type (clinical, administrative, eligibility, coding, timely filing), given an action disposition, and routed directly to our denial management team on the same day the remittance is processed. This eliminates the gap between denial receipt and denial action that allows appeal deadlines to expire.

05

Daily Bank Deposit Reconciliation

Every day, we reconcile total posted payments against actual bank deposits — confirming that the money recorded in your practice management system matches the money in your bank account. When discrepancies exist — missing EFT deposits, misdirected payments, duplicate postings, or bank processing delays — we identify and resolve them before they carry forward into the next day's AR balance. Monthly close reconciliations are delivered as a formal report.

06

Secondary & Patient Balance Carve-Out After Posting

After primary payer payment is posted, we identify accounts requiring secondary payer billing — applying the primary EOB as a crossover document, generating the secondary claim, and routing the remaining balance correctly. Patient responsibility balances are calculated based on actual payer payment, contractual adjustments, and secondary payment — ensuring patient statements reflect accurate balances from the first statement sent.

How Healthcare Logic Keeps Your AR Accurate Every Single Day

A five-stage daily remittance workflow — designed to process every payment, catch every error, and hand off every actionable item to the right team before close of business.

Stage 01
ERA & EOB Receipt
Electronic 835 ERA files are pulled from clearinghouse delivery queues each morning. Paper EOBs are received, scanned, and indexed into the processing queue by payer and date.
Stage 02
Claim Matching
Every claim line in each remittance is matched to the open claim in the practice management system — by claim number, patient, date of service, and payer — before any posting occurs.
Stage 03
Post & Validate
Payments and contractual adjustments are posted. Each payment is validated against the contracted fee schedule. Variances, denials, and secondary routing needs are flagged in real time.
Stage 04
Denial Routing
All denial reason codes are read, categorized, and routed directly to the AR and denial management team on the same day — with action type, appeal deadline, and payer contact information attached.
Stage 05
Bank Reconcile
Posted payment totals are reconciled against actual bank deposits before end of business each day. Discrepancies are identified, documented, and resolved before they carry into the next day's AR.
Accuracy + Speed + Visibility

Remittance Processing That Closes the Loop Daily.

Healthcare Logic's remittance team doesn't just post payments — it validates, reconciles, and routes every remittance transaction so that your AR balance, your bank balance, and your denial queue are all synchronized and accurate before your billing team starts work the next morning.

Same-Day ERA Processing — 4-Hour SLA

All electronic 835 ERA transactions are processed within 4 hours of clearinghouse delivery on business days. No backlog. No batch-processing delays. Payments posted the day they arrive mean your AR aging report is accurate as of today — not as of three days ago.

Automated Fee Schedule Variance Detection

Every payment is validated against your current contracted rates at line-item level. Underpayments are flagged automatically, documented with the contract rate versus paid rate, and routed to our AR team for recovery — so underpayments never silently close as accepted.

ERA Enrollment Support for Paper EOB Payers

For payers that still send paper EOBs, we manage the ERA enrollment process — submitting enrollment requests to payers and clearinghouses, tracking activation timelines, and transitioning accounts from paper to electronic as enrollment completes. Reducing paper EOB volume directly reduces posting labor and error rates.

Remittance KPIs in Logic Analytics Dashboard

Payment posting volume, same-day posting rate, underpayment recovery rate, denial capture rate, and bank reconciliation variance history are all tracked monthly in Logic Analytics — giving leadership a clear picture of remittance performance and the financial impact of variance recovery over time.

Remittance Performance Dashboard
Payment Posting Accuracy99.2%
Underpayment Recovery Rate87.4%
Same-Day Posting Rate98.6%
Denial Capture Rate100%
Posting Accuracy99%
Underpayment Recovery87%
Same-Day Posting99%
Daily
Bank reconciliation
every business day

Remittance Processing Configured for Your Payer Mix & Volume

Remittance complexity scales with your payer mix, claim volume, and contract diversity. Healthcare Logic's workflows are configured to match your specific environment — not a one-size-fits-all posting template.

FQHCs & Community Health Centers

FQHC PPS Rate & Encounter Reconciliation

  • FQHC prospective payment rate validation per encounter type and payer
  • Medicaid managed care plan ERA processing and encounter reconciliation
  • Medicare FQHC all-inclusive rate posting and overpayment detection
  • Sliding fee scale patient balance reconciliation post-posting
  • UDS productivity denominator alignment with posted encounter data
Multi-Specialty Practices

Multi-Payer, Multi-Provider Remittance Management

  • Provider-level payment segregation and posting across multiple NPIs
  • Fee schedule validation by payer, plan, and provider contract tier
  • Specialty-specific contractual adjustment application by service line
  • Capitation payment posting and reconciliation against encounter data
  • Monthly remittance reconciliation report by provider and payer
Hospitals & Health Systems

High-Volume Facility Remittance Processing

  • Facility and professional fee ERA processing with separate posting queues
  • DRG and APC payment validation against grouper-calculated expected rates
  • Outlier payment and stop-loss threshold tracking by payer
  • Interim and final claim payment reconciliation for inpatient accounts
  • Detailed monthly payer performance and underpayment trend reporting
Cardiology & High-Fee Specialties

High-Value Procedure Payment Validation

  • Cardiac procedure reimbursement validation against contracted ASC and office rates
  • Device implant and supply passthrough payment reconciliation
  • Global period payment posting and subsequent procedure billing management
  • Multiple procedure reduction rule validation per payer policy
  • High-dollar claim underpayment escalation and recovery tracking
Nephrology & Dialysis Centers

ESRD Bundle & Non-Bundle Reconciliation

  • ESRD monthly capitation payment posting and per-patient reconciliation
  • Non-bundle separately payable drug payment validation against ASP pricing
  • Acute dialysis and hospital-based dialysis ERA processing
  • Payer-specific ESRD rate table validation by patient plan type
  • Quarterly ESRD payment rate adjustment reconciliation
Behavioral Health Practices

Mental Health Parity & Session-Based Reconciliation

  • Session-based psychotherapy payment reconciliation by provider and payer
  • Mental health parity reimbursement rate validation against medical/surgical equivalents
  • EAP payment posting and coordination with commercial plan reconciliation
  • Telehealth reimbursement rate validation by payer and state policy
  • Annual benefit limit tracking and patient responsibility calculation post-posting

Frequently Asked Questions About Remittance Processing

Remittance processing is the workflow of receiving, interpreting, and posting payer payment information to the correct patient accounts and claims in your practice management system. Payers send payment explanations as electronic 835 transactions (ERAs) or paper Explanation of Benefits (EOBs). Each document contains payment amounts, denial reason codes, contractual adjustments, and patient responsibility amounts. Posting this information accurately to every claim — and reconciling it against the actual deposit received — is essential for maintaining a clean AR, identifying underpayments, and generating correct patient statements.
Posting errors compound invisibly over time. An unposted payment leaves a claim open in AR, generating unnecessary follow-up work and distorting aging reports. A payment posted to the wrong account creates a credit balance on one patient and an open balance on another. A contractual adjustment posted incorrectly inflates or deflates net revenue. A denial reason code ignored means no appeal is ever filed and the revenue is silently written off. Healthcare Logic's remittance team catches all of these error types daily — before they accumulate into AR problems that take months to untangle.
Yes. We process electronic 835 ERA transactions from all major payers and clearinghouses, and we also manually post paper EOBs for payers that do not yet send electronic remittance. For paper EOBs, we digitize, index, and post each remittance within the same business-day SLA as electronic transactions. We also work to enroll clients in ERA programs with payers that support electronic remittance but aren't currently sending it — reducing paper volume and posting time over time.
Every payment is validated against your contracted fee schedule at the time of posting. When the payer payment falls below the contracted rate — even by a small amount — we flag it as a variance and route it to our AR team for follow-up. Common underpayment causes include incorrect fee schedule application, missing modifiers in payer systems, plan-level contract mismatches, and reimbursement calculation errors. Systematic underpayment patterns across a payer are escalated to contract review. Logic Analytics tracks underpayment recovery by payer monthly.
Healthcare Logic posts all ERA and EOB payments within the same business day they are received — for ERA transactions typically within 4 hours of clearinghouse receipt. Daily bank reconciliation confirms that posted payment totals match actual deposit amounts before close of business each day. Paper EOBs are posted within 24 hours of receipt. Rush posting is available for month-end close, audit preparation, or practice acquisition scenarios.
Remittance processing is the first point of denial detection. When a payer sends a denial, it arrives embedded in the remittance — as a CO, PR, or OA reason code on an ERA or as a remark code on an EOB. Healthcare Logic's posting team reads every reason code at the time of posting, categorizes each denial, and routes actionable denials directly to our AR and denial management team for appeal. This same-day denial capture is what prevents balances from aging while denials sit undetected in unworked remittance queues.

Find Out What Your AR Is Actually Hiding

Get a free AR reconciliation audit from Healthcare Logic. We'll analyze your current posting workflow, identify undetected underpayments, and quantify the gap between what payers have paid and what's been accurately recorded in your AR.

Get Your Free AR Reconciliation Audit
Healthcare Logic RCM team