Suite 1300
Salt Lake City, UT 84111
Block-1 3rd Floor, Perungudi Bypass Rd, Perungudi,
Chennai - 600096
MGR Main Rd,
Perungudi, Chennai - 600096
Villupuram,
Tamil Nadu – 605602
Payment Posting & Reconciliation Services
Stop Payment Errors Before They Distort Your Revenue
Payment posting is where revenue becomes financial truth or error. Every dollar must be posted, reconciled, and validated. Anything less creates revenue leakage you may never detect.
Trusted by 100+ healthcare providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II
Four ways payment posting creates revenue risk
Underpayments Accepted Without Variance Review
Payer short-pays are posted as final without contract comparison, resulting in permanent, unrecoverable revenue loss across thousands of claims annually.
Payments Posted Without ERA/EOB Reconciliation
Manual posting without validating remittance data against the ledger creates discrepancies that skew AR balances, distort denial rates, and produce unreliable financial reports.
Deposits Unverified Against Posted Payments
Without ERA-to-bank reconciliation, discrepancies between what payers remitted and what was deposited go undetected, leaving revenue gaps invisible to finance leadership.
Contractual Adjustments Applied Incorrectly
Write-offs applied above contracted rates or without authorization permanently reduce collectible revenue, an error that cannot be recovered after the filing window closes.
ERA/EOB Posting Review
We process all Electronic Remittance Advice (ERA) and paper Explanation of Benefits (EOB) with line-item accuracy, posting each allowed amount, adjustment, and denial code against the claim and verifying rates before ledger.
Patient Payment Application
All patient payments, including copays, deductibles, and self-pay balances, are posted accurately against open balances, ensuring that patient statements reflect true remaining liability and that over-collection risk is eliminated.
Contract Adjustments & Write-Offs
We apply contractual adjustments within authorized parameters, using current fee schedule data and payer contract terms. Every write-off is documented, authorized, and auditable, preventing improper revenue reduction.
Secondary and Tertiary Billing Trigger
After primary posting, remaining balances are immediately evaluated for secondary or tertiary payer eligibility and cross-over claim submission, ensuring no available coverage layer is missed before patient balance assignment.
Denial Code Capture and Routing
Every denial and adjustment reason code (CARC/RARC) is captured at posting, categorized, and routed to the appropriate AR or denial workflow, connecting posting accuracy directly to downstream revenue recovery
Batch & Ledger Reconciliation
Daily posting batches are reconciled against remittance totals before close, verifying that total posted amounts equal total remittance receipts and flagging any batch-level discrepancies for same-day resolution.
ERA-to-Ledger Reconciliation
Reconciliation is not a monthly accounting step. At AnnexMed, reconciliation is a continuous financial control layer that runs parallel to posting, ensuring that what payers remitted, what was posted to the ledger, and what was deposited to the bank are always in agreement.
Ledger-to-Deposit Reconciliation
Variance Detection and Escalation
When posted amounts do not match remittance or deposit records, variances are flagged, classified by root cause (payer error, bank timing, posting error, contract dispute), and escalated for resolution before financial close.
Contract Review & Compliance Audit
Adjustment Authorization Audit
Every contractual write-off and non-covered adjustment is reviewed against authorization thresholds before application. Unauthorized adjustments are held and escalated rather than posted, preventing permanent, unrecoverable revenue loss.
Month-End Reconciliation
Every step in the revenue cycle before payment posting represents effort: authorizations obtained, claims submitted, denials appealed, AR followed up. Payment posting and reconciliation is where that effort is validated, or invalidated. It is the final mile.
Without accurate posting and verified reconciliation, revenue is uncertain. Reporting is unreliable. Underpayments are invisible. And financial decisions are made on data that does not reflect reality.
Receive ERA / EOB
Post With Precision
Reconcile to Ledger
Verify Bank Deposit
Flag Variances
Confirm Revenue Truth
Post with precision
Every payment applied to the correct claim, payer, and line item
Reconcile to truth
ERA, ledger, and bank deposit successfully verified in agreement.
Validate every dollar
Contract compliance, variance detection, underpayment recovery
Underpayment detection is built into posting, not handled separately
Real-Time Contract Rate Comparison
Every allowed amount on an ERA is compared against the contracted rate for payer, plan type, CPT/CDT code, and posting date, identifying underpayments in real time before acceptance as final.
Short-Pay Identification and Dispute Initiation
When a payer remits below contracted rates, the claim is flagged as a short-pay, removed from posting workflow, and routed to underpayment recovery track, including remittance documentation.
Variance Analysis and Payer Behavior Reporting
We track underpayment patterns by payer, plan, and service category, identifying systematic behavior (recurring low-pays, fee mismatches, bundling abuse) and escalating patterns to contract review.
Recoupment Demand and Follow-Up
For confirmed underpayments, we prepare and submit formal recoupment demands with supporting documentation, track follow-up through resolution, and capture all amounts in underpayment recovery reporting.
Balance Billing Threshold Verification
Before assigning any remaining balance to the patient, we verify that the patient liability is calculated correctly against the allowed amount and patient cost-share, preventing overbilling and compliance risk.
Annual Contract vs. Actual Payment Audit
We conduct annual reconciliation of contracted rates against actual payer remittance history, surfacing systemic underpayment gaps that individual claim review would not reveal and informing payer contract strategy.
AI-powered accuracy, anomaly detection before errors reach the ledger
Manual payment posting cannot scale with the volume and complexity of modern payer remittances. AnnexMed deploys AI-assisted posting and reconciliation tools that process remittances faster, flag anomalies earlier, and detect underpayments that manual review would miss.
Smart ERA Posting
High-confidence ERA lines are auto-posted against matched claims using AI-validated matching logic, reducing manual posting volume by 60–80% while maintaining full accuracy and audit trail documentation.
Real-Time Checks
AI monitors posting batches in real time, flagging discrepancies between ERA data, posted amounts, and ledger balances before batch close, catching errors manual review would typically surface days or weeks later.
Underpayment Detection
Machine learning models trained on contracted rate data and historical payer remittance behavior identify anomalies in allowed amounts, flagging likely short-pays and underpayments for human review and dispute.
Posting Optimization
AI-generated posting analytics identify high-error payers, problematic adjustment codes, and inefficient manual posting workflows, continuously refining protocols to reduce error rates and improve throughput.
Measurable financial accuracy, across every posting and reconciliation metric
Metric
AnnexMed Performance
Posting Accuracy Rate
>99%: every payment applied correctly against remittance and contract
Reconciliation Accuracy
100% ERA-to-ledger and ledger-to-deposit match target, with same-day variance escalation
Underpayment Recovery Rate
3–8% incremental net revenue recouped annually through short-pay detection and dispute
Posting Turnaround Time
24–48 hours from remittance receipt to ledger finalization across all payer types
Variance Resolution Time
<72 hours for flagged discrepancies from identification to resolution confirmation
Client Retention Rate
91.1%: reflecting consistent financial accuracy and reporting reliability
Manual payment posting cannot scale with the volume and complexity of modern payer remittances. AnnexMed deploys AI-assisted posting and intelligent reconciliation tools that process remittances faster, flag anomalies earlier, and detect underpayments that manual review would miss.
Six reasons annexmed delivers financial accuracy that others miss
Validation-First, Not Posting-First
Most RCM vendors post first and reconcile later. AnnexMed validates contract compliance, remittance accuracy, and batch totals before finalization, preventing errors rather than correcting them after they reach the ledger.
Underpayment Detection Is Standard, Not Optional
Contract rate comparison is embedded in every posting workflow. Every allowed amount is validated against active fee schedules before posting, turning underpayment detection from a periodic audit into a continuous control.
Three-Layer Reconciliation as Default
ERA-to-ledger, ledger-to-deposit, and contract-to-actual reconciliation run in parallel on every account, giving leadership verified financial clarity and operational insight that single-layer reconciliation cannot provide.
AI-Assisted Anomaly Detection
Machine learning models monitor posting patterns and payer remittance behavior in real time, flagging statistical anomalies, systematic short-pays, and recurring discrepancies before they accumulate into material revenue gaps.
AR & Denial Integration
Our posting workflow is directly integrated with AR follow-up and denial resolution, denial codes, underpayments, and unresolved variances route immediately to the correct recovery track rather than sitting in a posting queue.
Audit-Ready Financial Documentation
Every posting, adjustment, write-off, and reconciliation action is documented with supporting remittance data, authorization records, and variance resolution notes, producing a complete, auditable financial record for every claim.
Request a free payment posting & reconciliation assessment
AnnexMed’s posting and reconciliation specialists audit workflows, reconciliation processes, and underpayment exposure, identifying errors, short-pays, and unreconciled deposits costing revenue.
20+ Years RCM Experience | 500+ Certified Specialists | All 50 States Coverage
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Proven RCM expertise. Delivered at scale.
For over 20 years, AnnexMed has delivered RCM solutions nationwide, combining expert billing, coding, and AR support to drive measurable results and growth.
- 20+ years of proven healthcare RCM experience
- 1,500+ professionals supporting billing, coding & AR
- 500+ certified coders across multiple specialties
- 99%+ compliance with HIPAA and security standards
- All 50 states served with consistent, scalable operations
