Posting of Payments and EOB Resolution

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Posting of Payments and EOB Resolution

All insurance payments are sent directly to your office and/or via insurance websites. Once payments are received, the EOB’s are either scanned, faxed or mailed to Pro Med Billing Solutions, we will then post the payments to the patient’s accounts. The EOB’s are then reconciled to ensure that the payment received was correct. If the payment received is incorrect, we follow up on the difference.

NOTE: Insurance companies frequently pay claims incorrectly. Without the proper follow-up your practice could be losing a significant amount of money related to write-offs. Your staff may not have the time to follow up on the short payments; however, Pro Med Billing Solutions makes it a priority.

We challenge UCR discounts or “procedures not covered” as to its legitimacy.

How many incorrectly paid EOB’s do you have? Do you know how to evaluate if an EOB is paid incorrectly? We’ve seen everything from:

  • Taking too much co-pay.
  • Not paying for all the procedures.
  • Leaving out a code.
  • Changing the code we filed.
  • Stating the procedure is not covered when they paid for the same procedure on the last EOB.
  • Stating the patient met their maximum, when they didn’t.

These are just some of the reasons insurance companies pay incorrectly, which will result in lost profits.

One of our most important functions is reviewing the EOB and evaluating whether the claim was paid correctly.