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Your payers paid. The question is whether they paid what your contract says. Qualigenix posts every ERA and paper EOB at the line level, checks each allowed amount against your fee schedule, and sends short payments to follow-up instead of writing them off. Denials are tagged with their CARC and RARC codes. Patient balances move to statements once insurance posting is done. A batch closes only when posted dollars match the check or EFT exactly.
Outsourcing payment posting to Qualigenix means every ERA (835) and paper EOB is applied line by line inside your own EMR or practice management system, with CO, PR, OA, and PI adjustments recorded against the payer's reason codes. Each paid line is checked against the expected allowed amount on your fee schedule, so underpayments go to a follow-up queue instead of being written off as contractual. Denied lines are tagged with their CARC and RARC codes and routed to appeal or correction. Every batch is reconciled to its check or EFT total and closes only at a $0.00 difference. Across its client practices, Qualigenix holds a 97.7% net collections rate, and onboarding takes 6 days on average.
| Metric | Result |
|---|---|
| Allowed gap between posted total and check or EFT total before a batch closes | 0 |
| Compliance and audit pass rate across client audits | 0 |
| EMR and EHR platforms supported, so posting happens in your system | 0 |
| Charges handled across client practices | 0 |
| Metric | Result |
|---|---|
| Net collections rate across client practices | 0 |
| Average days in A/R, down from 54 | 0 |
| Share of worked denials overturned on appeal | 0 |
| Cash-flow improvement, average across client practices | 0 |
Qualigenix handles posting from the moment a remittance arrives to the moment its batch closes. Insurance and patient payments are posted by the same team, so nothing waits in an unapplied bucket for someone to claim it.
Electronic remittances (835) from your clearinghouse or payer portals are auto-matched to claims by claim number, patient name, date of service, and CPT code. Unmatched claims are searched by account number, claim number, insurance ID, and date of service before anything is applied. Paper EOBs and mailed checks are keyed by hand under their own batch, after the day's ERAs.
Each CPT and HCPCS line is posted with its billed, allowed, and paid amounts, then adjusted with the payer's reason code: CO-45 for the contractual write-down, PR-1, PR-2, and PR-3 for deductible, coinsurance, and copay. A line is finished only when allowed equals paid plus patient responsibility, and billed equals allowed plus adjustments.
The paid amount on every line is compared with the expected allowed amount from your contracted fee schedule. Short payments and overpayments go to a follow-up work queue with the variance noted, so they get worked instead of disappearing into a contractual adjustment.
Denied lines are identified by their CARC and RARC codes and marked appeal required, correct and resubmit, or patient responsibility. Denials such as CO-50 (not medically necessary) and CO-29 (filing limit expired) get notes and a follow-up task before the batch closes.
Once insurance posting is complete, remaining patient responsibility moves to patient A/R and the statement queue, so no balance sits under insurance by mistake. Crossover status is checked on every primary payment, and a secondary claim is generated when the primary payer didn't forward it.
Every batch is balanced against its check or EFT total and closes only at a $0.00 difference. Closed batches can't be edited without supervisor access. You get a Payment Posting Summary, Adjustment Report, Denial Analysis, Underpayment Report, and Batch Audit Report, backed by random QA audits on posted claims.
Qualigenix onboards a new practice in 6 days on average and posts inside your existing EMR or practice management system, so payments keep getting applied while the work moves over.
What practice managers ask before handing payment posting to Qualigenix.
A payment posting service applies insurance and patient payments to the right claims and service lines, records each adjustment with the payer's reason code, and moves remaining patient responsibility to patient A/R. Qualigenix also flags underpayments and denials during posting and reconciles every batch to its deposit before closing it