The healthcare provider revenue cycle consists of several key components, but one that often warrants a critical assessment is cash posting. In some systems, payment posting simply includes insurance and patient receipts. However, in many healthcare systems, cash posting includes other department receipts (e.g., dietary, birthing classes, sports physicals) and a number of balancing and reconciliation tasks. The process is an integral part of the provider revenue cycle and involves many different internal and external stakeholders, including revenue-generating departments, fiscal services, billing, follow-up, patient financial services, the financial institution, and ultimately, the patient.
Unfortunately, healthcare systems often have backlogs in the cash posting area, and there are numerous opportunities for improved efficiency. Cash posting is a unique area of the revenue cycle that does not necessarily have a curriculum, certification, or educational series to teach the intricacies of the work. The leading national vendors for electronic health records (EHRs) have created advanced technology to help automate much of the process but integrating effective workflows to complement the technological advancements is key. If cash is not posted in a timely manner, there can be many downstream impacts, including appeal timeliness, documentation request submissions, and timely secondary billing.
Further, if cash is not posted correctly, billing errors with patients, clients, account balancing, and follow-up could result. This often leads to non-value-added work — such as follow-up teams statusing claims already paid, and patient financial services handling calls from patients who have paid on their accounts but have not received proper credit
Gathering the Team for Improved Payment Posting
To ensure these errors and inefficiencies are limited, a comprehensive evaluation and assessment that includes all stakeholders may be performed. The process should likely include open communication and identification of both deficiencies and opportunities, as well as a collaborative implementation of new processes. Stakeholders to consider are cash posters, fiscal services, billing, and follow-up teams, patient financial services, IT, EHR technical support, the management team, and the financial institution.