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Payment Posting

Payment Posting (Manual & Electronic) We ensure prompt and accurate posting of payments and adjustments, whether received through Electronic Remittance Advice (ERA) or traditional paper EOBs. This process is essential for maintaining up-to-date patient and payer account balances and ensuring smooth cash flow.
1. Zero-payment and Short-pay Identification : We flag and investigate claims that result in no payment or are underpaid to address issues quickly and minimize revenue loss.
2. Automated ERA Integration and Remittance Logic : Our systems automate payment posting by interpreting ERA data accurately, reducing manual work and posting errors.
3. Cross-checks with Fee Schedules and Contracts : Every payment is validated against agreed-upon rates to ensure compliance and to identify potential underpayments for timely follow-up.

Planning and sketching

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Team working

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User experience Testing

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ACA Commercial Risk Adjustment Coding

We support accurate and compliant risk adjustment coding for Affordable Care Act (ACA) exchange-based plans by capturing all eligible diagnoses that impact a member’s Risk Adjustment Factor (RAF) score. Our certified coders conduct thorough medical record reviews and detailed abstraction to identify and document all relevant chronic and high-impact conditions. By aligning with HHS-HCC risk models and payer-specific requirements, we help health plans enhance RAF scores, ensure appropriate premium transfers, and maintain compliance with regulatory standards—ultimately supporting both financial performance and care quality.