PAYMENT POSTING / ADJUDICATION,
ADJUSTMENTS &
DENIAL PROCESSING

Whether you have electronic lock-boxes or receive hundreds (or thousands) of EOB's mailed weekly to your office, this information must all be posted to a patient's account in a timely manner. Adjustments or denials must be adjudicated promptly to insure that patients understand their payment responsibilities. Of equal importance is to have the practice's accounts receivable reflecting the most current payment receipts.

This is another necessary function that consumes considerable labor, time and therefore cost for a practice regardless of whether it is done at each office or at a central business site. Using Medusind's Payment Posting service, your staff is freed from this labor intensive function. You will have the comfort of knowing that all payments will be posted and reconciled on the day we receive the EOB's. At the end of the month your monthly payment will be posted and reconciled. In addition, you can also have Medusind handle the adjudication of a claim (see below) based upon your specific instructions.

Getting this information to Medusind is easy. If you are receiving paper EOB's you need only scan them to a secure FTP site for us to work with. If you have electronic lock-boxes, we can interface with them to get the information we need. Being tied in to your practice management software allows us to make all information available to you on a real time basis. As an added benefit of our Payment Posting service, we will index the EOB's to the appropriate patient record (subject to your practice management software) allowing you to find specific EOB's by simply going to a patient record. This alone can save you many hours in searching for a particular EOB to answer a specific question.

Adjudication, Adjustment and Denial Processing

There are many times when an insurance carrier does not pay the entire claim. In some cases you are aware of that when submitting the claim but at other times it comes as a "surprise." When the payment received does not equal the claim amount, action has to be taken. The difference can be written off, moved to the patient responsibility or re-submitted to the insurance carrier. Medusind will handle the final adjudication of a claim based upon parameters provided by its clients. Our staff will contact the insurance carrier to determine reason for non-payment and, based upon your wishes, take the appropriate action. At times this may simply mean going into your practice management system to resolve the issue; at other times Medusind may contact the appropriate office for further information. If the claim is to be resubmitted, Medusind will do so. In any event, this service will take away the labor, time and cost associated with your staff handling this function.