How it runs for medical practices and clinics
Paper EOBs and lockbox checks are keyed the same way. Patient payments from the front desk, portal and card-on-file are applied by account. Unapplied cash is cleared within two business days.
What is cash application?
Cash application means matching money received from customers to the invoices it pays and recording that in the accounting system. It covers bank receipts, checks, lockbox files, card payouts and remittance advices, including partial payments, deductions and payments with no reference. Done well, the aging is accurate and no customer is chased for an invoice they already paid.
What we handle for medical practices and clinics
- Import 835 remittances and apply each line to its claim with adjustment reason codes
- Key paper EOBs and lockbox checks to claims with the same discipline as ERAs
- Apply front-desk, portal and card-on-file patient payments to the right account
- Flag denials, underpayments and takebacks for the AR team the same day
- Clear unapplied cash within two business days with a documented reason
The KPI that matters here
ERAs and patient batches applied within two business days of deposit, with unapplied cash below one percent of monthly receipts.
Medical practices compliance notes
HIPAA
Claims, remittances and patient statements are protected health information. We sign a BAA, staff are HIPAA-trained, access to your practice-management system is role-limited with MFA, and ledger entries carry claim or batch numbers rather than patient names or diagnoses.
Payer rules and timely filing
Every payer contract sets timely-filing limits, appeal windows, coordination-of-benefits rules and refund procedures. Medicare allows 12 months from the date of service to file; many commercial payers allow less. We log deadlines per payer so unpaid claims are worked before they age out.
Overpayment refunds
Identified Medicare and Medicaid overpayments must be reported and returned within 60 days of identification under the Affordable Care Act. We age credit balances by payer, prepare refund batches for your approval, and document the dates so the practice can show it acted in time.
Patient credit balances and unclaimed property
Patient overpayments that go unrefunded may become reportable unclaimed property under state law after a dormancy period. We list patient credits monthly, prepare refunds for your approval, and keep records that support any state filing your counsel advises.
Medical practices software we work in
- Kareo (Tebra)
- AdvancedMD
- QuickBooks Online
- Gusto
- Bill.com
- Stripe
- athenahealth
- eClinicalWorks
- All 50 platforms
More for medical practices and clinics
Other services for medical practices
Frequently asked questions
What is the difference between an ERA and an EOB for my books?
An ERA is the electronic version of the explanation of benefits, delivered as an 835 file that can be imported and applied automatically. An EOB is the paper or PDF version that must be keyed by hand. Both carry the same information: what was billed, allowed, adjusted, paid and left to the patient. We apply both at the claim line so the aging is accurate.
How do you handle a payer takeback inside an ERA?
A takeback appears on the ERA as a negative line recovering an earlier payment. We post it against the original claim, note the payer's reason, and open an appeal or reconsideration if the takeback appears wrong and is still inside the window. Posting it against the wrong claim, or ignoring it, is why practice agings drift from the truth.
Do you apply patient payments at the front desk?
Front-desk staff collect copays and known balances at check-in and post them in the practice-management system. We reconcile the daily front-desk batch to the deposit and to the processor payout, resolve differences with the office manager, and apply any portal or mailed payments that arrived that day. The result is one clean patient ledger and a bank that agrees.
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