Payment Posting FAQs
Will the patient account number be on the EOBs?
Yes, anything that bills out of RevFlow will have the patient account number. The patient account number comes after the three digits that make up your company code, so be sure to drop those before entering the account number. Tip: when you’re first starting out, this is actually one of the best ways to know if the payment belongs in your old system or RevFlow. If the patient account number doesn’t start with your RevFlow company code, it belongs in your old system.
Can I auto-post a mixed EOB?
Yes. You can auto-post EOBs that contain payments for services that are in your old system and in RevFlow. This is actually the easiest way to handle mixed EOBs. Payments meant for your old system will generate a Patient Not Found error, and RevFlow payments will post automatically.
If we are transferring to a secondary payer, how do we print the claim?
You don’t need to. When you transfer the charge to a secondary payer electronically, it happens automatically overnight. If the secondary needs to go to paper, we handle the printing and mailing process for you. In the beginning, we may not have the original EOB. In those instances, we’ll request the file from you and send out the secondary claim once we receive the original EOB.
What if an insurance pays interest on an EOB?
If the insurance pays interest and it’s on an ERA (electronic EOB), it will post and balance automatically, you won’t even notice it. If the interest appears on a paper claim, there are a few ways you can handle this depending on whether the interest is allocated to a specific charge or not. Check out this video for more information.
What if a claim is denied? For example what if Medicare denies a claim for not having a KX modifier?
Any electronic EOB (ERA) that comes into RevFlow with a denial will automatically load on the Zero Pay report found here: E-EOB > Open Zero Payments. The denials will appear in your Release ERA page, but will be worked from the Open Zero Payments report. We’ve purposely ensured denials are worked on a different page to create separate worklists. Check out this video for more information.
Do I need to add the Payer Rules every time I auto-post?
No, payer rules only need to be added the first time that payer ID flows into your RevFlow account. It is a one-time setup step per payer. The only caveat is if the payer changes their ID, then you’ll need to complete the Add Payer Rules step. Click here for more information about setting up your Payer Rules.
What is required for an ERA to post in RevFlow?
In order for an ERA to auto-post in RevFlow via the Release ERA page, it must meet the following criteria.
The claim must have:
- A Revflow account number: If a RevFlow account number is not listed on the EOB, it will hit the error report. This typically occurs with payments that belong in your other system (during your transition period)
- A date of service that is present in RevFlow
- CPT Codes have to match and exist in RevFlow
- Payment tied to a specific CPT code
- Paid units that match the billed units
Note: The claim cannot contain an excluded code like a denial. These will be listed on this report but not worked here. Any ERA that doesn’t meet all these rules will end up on your the error report at the bottom of your release ERA page.