Payment Posting Automation

Sources and review notes

These links support definition-level research and do not establish the regulatory status, safety, or suitability of any product.

CMS explains that an EFT orders the transfer of funds while an ERA explains claim payment and adjustments, including contract, secondary-payer, coverage, copay, and coinsurance context. CMS's Medicare remittance guidance describes ERA and paper remittance advice, group codes, Claim Adjustment Reason Codes, and Remittance Advice Remark Codes, and the HIPAA Administrative Simplification page identifies the adopted payment and remittance standards and operating rules. These sources support standardized payment and remittance inputs but do not validate posting software, determine the correct account or ledger treatment, resolve payer contracts, or prove posting accuracy, reconciliation completeness, staff savings, or faster cash. Organizations must preserve the source ERA or 835 and EFT trace information, validate payer, payee, claim, service-line, patient, and account matching, apply current code and contract context, distinguish payment from adjustment and patient responsibility, detect duplicates and reversals, reconcile deposits to remittances and ledgers, route unmatched, partial, refund, recoupment, coordination-of-benefits, and crossover cases to qualified staff, and retain correction, approval, and audit evidence.

• Source 1: www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/transactions/health-care-payment-remittance-advice-electronic-funds-transfer
• Source 2: www.cms.gov/medicare/coding-billing/electronic-billing/health-care-payment-remittance-advice
• Source 3: www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/hipaa/adopted-standards-operating-rules