Remittance Processing Control Point
The remittance processing control point consists of posting or applying payments to the appropriate accounts / invoices. It is typically a data entry function, but like the claims control point, significant opportunity exists for automation. Either way, this process involves posting the information provided on the Explanation of Benefits (EOB) into the billing system. The information posted generally consists of payment amounts, contractual adjustments, co-pay / deductible amounts, and rejection codes. These data elements are critical because they drive the next step in the process. Rejected claims should be immediately routed to staff for follow-up and correction. Patient due balances, on the other hand, should be transferred to a patient financial class and billed on the patient's statement.
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