EOB POsting

Once we transmit claims to the insurance company (aka bill the insurance company for services we provided for the patient), they will return an EOB (explanation of benefits) back to us that will explain how much of what we billed they are paying, and how much is the patient’s responsibility. Daily, the finance team reviews EOBs as they come in from the insurance companies, and posts the payment and/or updates to the patient’s ledger.

It’s best to have multiple screens to complete this task, as you will have several programs running together to complete EOB posting.

  • To get started on posting EOBs, you will need to log into the Emdeon website. Click on the icon, click CONNECT, and it downloads the EOB report.

  • Next, you will need to pull up the EFT Payments spreadsheet on the server. To find this spreadsheet, go to the Company Drive, then click on the Finance dept folder, then the EFT payments folder, and select the EFT Payments spreadsheet with the correct year listed (i.e EFT Payments 2022).

  • Then in Eyecare, you will need to pull up the Remittance Policy report but going to Function, then Insurance Activities, then Remittance Posting. Choose the dropdown to pull all EOBs.

  • On Emdeon, go to time period 3 months.

    • Search payment screen

    • time period 3 months

    • Check ACH, NON, Unnamed

    • Click Search

  • Go back to Eyecare and change pay type to “O”

  • Record on the EFT payments spreadsheet.

  • Repeat this process one by one until all EOBs have been accounted for.

  • Eyecare will auto-post on the ledger what the insurance payment was, but you must also add notes and print statements as needed.

    • If insurance paid a partial amount, check if the patient has a secondary insurance that needs to be billed

    • If no secondary insurance is listed, add a note to the ledger explaining that “Pt owes $$$ co-insurance (or deductible) for (date)/sent stmt/your initials”

    • Then print out a statement to send to the patient for the balance they owe, by:

      • Going to the patient’s ledger

      • Click on Print

      • Click Statement

      • Choose statement reason (co-insurance, deductible, etc)

      • Then mail the statement at the end of the day, being sure to add postage from our postage machine.