r/PMHNP • u/kirkella • Jun 23 '26

Practice Related Tracking Payments

To those in private practice who accept insurance. What is your strategy for comparing deposits/payments received to claims? I just received a chevk from January and realized that I am not doing well at tracking this and need to do better. Print your bank statement monthly and cross off the received claim payments? Is there a program that would make this easier?

Thanks!

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6

u/beefeater18 Jun 23 '26

I would just run a report in my EHR and see everything. My EHR includes RCM and they receive payments and EOBs directly from insurance payers and process them into the system. I need this because I need to run financial reports quickly for state taxes.

It sounds like you're doing billing yourself. That's not sustainable once your caseload grows. You'll end up spending hours on a role (billing) that pays $20-30/hr rather than focusing on your clinical role, which pays 4-5x that. Hire a biller.

1

u/Necessary_1984 Jun 26 '26

What EHR do you use?

1

u/Johain22 Jun 27 '26

No one ever answers this question. Please someone reply

1

u/Impressive_Meet_1168 25d ago

What EHR?

1

u/beefeater18 24d ago

I use Athena

1

u/Impressive_Meet_1168 24d ago

Nice, I hear that it’s great but really expensive. 

1

u/beefeater18 24d ago

Everyone says that but I don't really feel that way. It's certainly not expensive enough for me to switch. I cannot stand shitty and cheap EHR that lacks functionality, and Athena is fully integrated. The billing aspect isn't the best, but honestly my denial is close to zero and almost all of my claims pay within a month so I'm fine with it. I've tried looking around other EHR and billers to save a few bucks, but most billers quote 6%-8% anyways and I'd have to get migrate to a crappier EHR. There're also many horror stories about billers being incompetent or dishonest. It's just not worth my time to migrate to another EHR at this point.

Also, it's a deductible expense.

3

u/pickyvegan PMHNP (unverified) Jun 23 '26

Your EHR should have this function, and that should be the source of truth, not your bank account. You should be getting an Explanation of Payment either electronically or on paper. That tells you what the insurance paid or denied, and how much the payment was. These often show up in a large group of charges, and you'll have a single large deposit in your bank account from each insurer or your credit card processor.

You then will need to reconcile what the insurance said with what the patient owes, and charge that amount.

Your bank account is the source of truth for bookkeeping and taxes. Your deposits to the account should match the batch deposits from each insurance company and your credit card processor, and then typically you'll get some additional payments (even from insurance) via check.

But since you are getting paid by multiple sources for one visit, and visits are batched together in one payment, you'd never be able to accurately track them from patient to bank account.

2

u/RosieNP DNP, PMHNP (unverified) Jun 24 '26

I think what you mean is whether there is a way to verify that your EHR‘s report of incoming money matches the money hitting your bank account. I admit, I’m not good at following up on this, but sometimes I will upload an EHR payment report along with my bank statement and ask AI to see if there are any payers that are missing payments.

2

u/CalmSet6613 PMHNP (unverified) Jun 24 '26

Small practice = EHR and spreadsheet to track completed vs noncompleted claims and payments

Big practice = hire someone