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HI
Healthcare Payment Posting

Consolidate all your claims payment touch points into single payments dashboard
Kaiser Permanente implements HiPaaS to improve remittance reconciliation for all non Kaiser claims payments across its 5 regions.
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  • Improve A/R accuracy & Improve net revenue of the practice
  • Improve remittance reconciliation
  • Reconcile Claims with Payments including 835 ERA and Treasury files.
  • Al Driven and rule based EFT, ERA and Claims Invoice Match
  • Reduce denial rate by getting view of rejected or unpaid line items 
  • Research Payer rejections and denial reasons
  • Track secondary submissions
  • Transfer the balance to the patient account

Improve Payment
Accuracy and Timeliness

ELECTRONIC REMITTANCE ADVISORY (ERA) POSTING

  • Validate claims submission data via loading outbound 837 files

  • Reconcile Claims with Payments including 835 ERA and Bank Treasury files.

  • Load 835 files and reconcile with outgoing 837 files

  • Load Treasury files and compare with 835 files

  • Create missing ERA entries and bank entries

  • Split ERAs if needed for feeding data back into Epic or EHR instances

  • Al Driven and rule based EFT, ERA and Claims Invoice Match

  • Reconciliation to claims data to the service line level

  • Work queues for manual reconciliation and data correction.

  • Post each line item to the respective patient accounts

  • Resolve missing EOBs, adjustments, write-offs, and balance transfers.

  • Accept online payments in different data formats including data positioned, csv and excel.

RESOLVE WORK QUEUES

  • Report and reroute denied claims including manual workqueues for working denials

  • Rework and re-submission to payers in a timely manner.

  • Check the secondary payer information

  • Transferring the balance to the patient account

  • Making adjustments/ write-offs as per defined policies

TRACKING AND RESUBMISSION

  • Regular checks of the latest claim status including daily and on demand reports

  • Realtime Claims status check

  • Track claims to payment

  • Secondary Insurance submission

  • Resubmission for errors

  • Real time A/R view

DENIAL POSTING & RESEARCH

  • Research Payer rejections and denial reasons​

  • Report and reroute denied claims including manual workqueues for working denials

  • Rework and re-submission to payers in a timely manner.

  • Check the secondary payer information

  • Transferring the balance to the patient account

  • Making adjustments/ write-offs as per defined policies

POSTING PATIENT RESPONSIBILITY PAYMENT

  • Integrate with Patient Portal for collecting patient portion.

  • Post to collection Agencies

  • Resolve any credit balances

  • Integrate to Payment Gateway to collect patient portion.

  • Integrate to generate notification and reports to send to collection agencies

  • Making adjustments/ write-offs as per defined policies

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