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How do I track patient payments and insurance reimbursements?

Payment tracking in a medical practice involves two distinct streams that need separate handling. Patient payments include copays collected at the time of service, deductibles, coinsurance, and payments on outstanding balances. Insurance reimbursements come weeks or months after claims submission and require careful matching to original charges.

Start with your practice management system. Every payment should be posted against the specific charges it covers. When a patient pays a $40 copay at check-in, post it to that day’s visit. When an insurance payment arrives, post each line item from the explanation of benefits to the corresponding procedure code. Lump-sum posting makes it impossible to know which services have been paid and which are still outstanding.

Use electronic remittance advice whenever possible. ERAs allow automatic posting of insurance payments directly into your practice management software, reducing manual data entry and errors. If you’re still receiving paper EOBs and manually posting payments, you’re spending hours on work that could happen automatically.

Reconcile posted payments to bank deposits daily or at least weekly. The payments you post in your practice management system should match what actually hits your bank account. When they don’t match, something went wrong. Either a payment was posted incorrectly, a check was lost, or a deposit was recorded in the wrong amount. Working with a medical billing service in Macomb can help catch these discrepancies before they become bigger problems.

Track patient balances separately from insurance AR. After insurance pays their portion, remaining patient responsibility needs to go on a patient statement. Many practices lose money because patient balances sit uncollected. Set up a system to send statements promptly and follow up on balances over 30 days.

Watch for underpayments from insurance. Compare what you billed, what the contract allows, and what was actually paid. Payers make mistakes or apply incorrect fee schedules. If you’re not checking, you’re leaving money on the table.

Your practice management system handles the clinical side of payment tracking, but your accounting software needs to reflect the same reality. Revenue should match what was actually collected, not what was billed. Many practices show inflated revenue because they’re booking charges before collection.

Proper medical billing and coding is the foundation for accurate payment tracking. If claims go out with errors, everything downstream becomes harder to reconcile. Denials increase, patient balances get confused, and the practice spends more time fixing problems than seeing patients. The goal is knowing at any moment how much you’re owed, by whom, and for how long.

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More Questions

What is the difference between medical billing and medical coding?

Medical coding translates diagnoses and procedures into standardized codes. Medical billing submits those codes as claims and handles collections. They work together in the revenue cycle, and mistakes in either function lead to lost revenue.

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What are common medical billing errors that cost practices money?

Common billing errors include failing to verify patient eligibility, using incorrect procedure or diagnosis codes, missing timely filing deadlines, and not following up on denied claims. These mistakes can cost practices thousands in lost revenue each month.

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How do I reduce claim denials at my medical practice?

Most claim denials are preventable with proper front-end processes. Focus on eligibility verification, prior authorization, accurate coding, and complete documentation to get claims paid the first time.

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How does revenue cycle management work for dental practices?

Revenue cycle management covers every step from scheduling to final payment collection. It includes eligibility verification, claims submission with proper CDT codes, payment posting, denial management, and AR follow-up.

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How do dental practices manage insurance billing and patient copays?

Dental practices manage billing by verifying coverage before treatment, submitting claims with accurate CDT codes, posting insurance payments, and collecting patient portions at the time of service.

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Why are my insurance claims getting denied?

Insurance claims get denied for reasons including missing prior authorization, eligibility verification failures, coding errors, and incomplete patient information. Most denials are preventable with proper front-end processes.

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