The Issue: Payment Postings Created Financial Blind Spots
Early last year, a large multi-specialty healthcare group faced a growing operational strain. Payments were not being posted accurately (or at all) creating significant variances, mounting A/R issues, and limited visibility into revenue status.
Their challenges were multifaceted. A backlog of unposted Explanation of Benefits (EOBs) had accumulated, both within and outside the organization’s bank deposit log (DBU). In many cases, payments were posted in the revenue system partially or inaccurately with key details either missing or misapplied. Also, when Electronic Remittance Advices (ERAs) were auto-posted, contractual adjustments were frequently skipped, thereby inflating outstanding balances and distorting the true A/R picture.
These posting errors and incomplete reconciliations compounded over time, creating a bottleneck that severely threatened financial performance and operational transparency.
Diagnosing the Root Causes and Realigning the Workflow
When Access Healthcare was hired, the revenue cycle leader said, “I have two expectations: get paid quickly and get paid correctly. I want to immediately understand what is happening and why.”
Access Healthcare immediately sprang into action. To drive this turnaround, we deployed a specialized cross-functional team with deep expertise spanning the payment lifecycle.
A dedicated group of 10 team members zeroed in on clearing outstanding rejections and tackling items on the unbilled report, ensuring that clean claims efficiently advanced forward.
Meanwhile, 34 specialists concentrated exclusively on payment posting, processing ERAs and lockbox payments from payers to bring accounts up-to-date and prevent future lag.
A three-member team handled credit balance reviews, identifying and correcting claim-level overpayments and initiating refunds as needed.
The largest contingent, 83 professionals, was assigned to accounts receivable, denials, and correspondence. This team was responsible for following up on unpaid invoices, resolving denials, and responding to payer communications to drive claims to resolution.
Together, these coordinated efforts from Access Healthcare restored visibility, accuracy, and financial control.
Positive Improvements Across Every Metric Within Two Months
Within 60 days, the backlog had been cleared, errors were reconciled, and the healthcare organization returned to real-time payment posting. Posting accuracy and reconciliation processes became consistent and scalable. Key outcomes included:
All backlogged and pending payments posted and reconciled
Payment posting process brought fully current
A/R balances corrected by addressing incorrect or missing payments and adjustments
Payment posting workflows revised to ensure adjustments match contract expectations
Financial and operational outcomes also showed a clear improvement within the initial two-month timeframe:
Monthly payments increased from $9.7M to $10M
Factored payments per visit rose from $94.50 to $95.75
ROPEN queue dropped dramatically from approximately 34,000 to 2,500
SLA performance (NCR) improved from approximately 89 percent to 92 percent
An Investment in Process Pays Dividends in Performance
With visibility restored, backlogs eliminated, and A/R stabilized, the healthcare group is now operating with far greater financial clarity and control. This engagement highlights how the right combination of technology, specialized expertise, and process alignment can drive measurable improvements, even in the most complex payment environments.
“The way the work is done matters and Access Healthcare does it best,” the revenue cycle leader said.