What is payment posting in medical billing?

Financial metrics

What is Payment Posting?

Also called: cash posting · ERA posting

Payment posting is the recording of payer and patient payments against the correct claims and service lines, including contractual adjustments, write-offs and patient responsibility. Done well it reconciles to the bank deposit; done poorly it corrupts every AR and denial report downstream.

The distinction that matters is between a contractual adjustment — the difference between billed charge and contracted allowed amount, which is expected and not collectible — and a write-off, which is revenue you were entitled to and chose to abandon. Posting the second as the first hides denial losses inside a number everyone assumes is normal.

Underpayments hide here too. A payment that posts without anyone comparing the allowed amount to the contracted rate is how systematic payer underpayment goes unnoticed for years.

Where Vizora handles this

AR management

Primary sources

Where "Payment Posting" is defined by the bodies that set the rules, rather than by us.

MGMA DataDive and MGMA Stat (opens in a new tab)
Medical Group Management Association — The practice-level operations benchmarks — days in AR, denial rate, cost to collect — that physician groups are actually measured against.
MAP Keys revenue cycle metrics (opens in a new tab)
Healthcare Financial Management Association — Standard definitions for revenue cycle KPIs. Worth reading precisely because HFMA defines the metrics without publishing public target values — a distinction most vendor marketing ignores.
Medicare Physician Fee Schedule lookup (opens in a new tab)
Centers for Medicare & Medicaid Services — Official allowed amounts by CPT/HCPCS code and locality. The reference point most commercial contracts are written against as a percentage.

Last reviewed August 20, 2026

Related terms

ERA

An electronic remittance advice, transmitted as an X12 835 file, is the payer's electronic explanation of how a claim was adjudicated. It reports what was allowed, what was paid, what was adjusted and why — using CARC and RARC codes — and it drives automated payment posting.

Contractual Adjustment

A contractual adjustment is the difference between a provider's billed charge and the contracted allowed amount with that payer. It is not a loss and not collectible from the patient — it is the discount agreed to in the contract, and it must be recorded separately from write-offs.

Underpayment

An underpayment is a claim paid below the contracted allowed amount. Unlike a denial it produces no alert, posts cleanly, and closes the claim — which is why systematic underpayment can run for years without anyone noticing. Detection requires comparing every payment against a loaded fee schedule.

Days in AR

Days in accounts receivable measures the average time between billing a service and collecting payment. It is calculated as total accounts receivable divided by average daily charges. It is the single best summary indicator of revenue cycle health, because every upstream failure eventually shows up in it.

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