I’ll bet you didn’t know time travel was possible. Well, with some healthcare IT systems, it is. It’s not uncommon in billing to find yourself in a situation where there’s some unapplied balance. You receive an ERA, an EOB, or some form of payment, and for whatever reason, you can’t post the entire amount—or even some or all of that payment. It could be that you’re missing some patient information. It could be any combination of things.
Unapplied Balances and Payment Posting
Everyone knows that unapplied balances occur sometimes, and it may take anywhere from days to weeks, or even months, to get the information required to post that payment correctly. So what happens when you receive a payment in one period of time, like a particular month, and then that unapplied balance carries over into a future period? You get that information and then post that payment in a future time or payment period.
For example, let’s say a payment is received in May, but you don’t have the necessary information, resulting in an unapplied balance. That balance then carries over to September. Now, when the information is finally collected, the payment is posted in September. So, what’s the post date for that payment?
The Issue with Retroactive Posting
If you get the information in September and post it in September, even though the payment was received in May, in theory, it should show a post date of September. But that doesn’t always happen with some systems. We’re dealing with a situation where a system retroactively posts the payment to May.
Why Does This Matter?
Why does this complicate things? Well, looking at periods of time from a reporting standpoint serves different functions. For example, when looking at charges by date of service, once a particular period closes, it should never change. You can’t time travel back and see a patient retroactively, right?
However, it’s possible that someone didn’t post something, so the charge never got entered. But for the most part, you shouldn’t be able to create something that happened months ago after that period has closed. For instance, sometime within a couple of days after May, you should never be able to post something to that period because whatever patient encounters occurred were posted, and those charges were entered into the system.
The Complexity of Submission Dates
When looking at charges by submission dates, those, of course, could change over time. If you look at what was submitted in the month of May, it should never change. But if you look at the dates of service for May and when they were submitted, they might be submitted in May, June, July, or whatever future date. That can extend the long tail of submissions. Therefore, if you look at charges for May submitted overall time, future dates could variably change, and those charges could increase, for example. But a closed period should never change.
