Billing
Payment posting
Posting is what makes money count. Every payment is applied to the charges it pays, the account balance is restated from one identity, and one dated row is written to the payment ledger that reports read.
Written for: Billing and RCM teams · Finance
The rules every posting follows
| Field or control | What it means |
|---|---|
| Charge balance | Total charge minus payments minus adjustments. Patient responsibility is the part of that balance the patient owes, not an extra amount. |
| Account balance | Total charges minus patient payments minus insurance payments minus adjustments, restated after each posting rather than nudged up or down. |
| Payment ledger | One dated row per payment or refund, patient or insurance, with where it came from. Writing the same movement twice is refused by the database. |
Posting paths
| Field or control | What it means |
|---|---|
| Payer remittance (835 or keyed EOB) | Line by line onto charges, with contractual adjustments and patient responsibility. Replay-safe. See remittance processing. |
| Patient payment recorded by staff | The account's Payments tab. Applied to the oldest patient-owed charges first, then to self-pay balances that are not on a claim. Anything left over stays on the account as a credit rather than being applied to a line billed to insurance. |
| Card payment (portal or staff) | Posted the same way when Stripe's signed webhook confirms the payment succeeded, exactly once. |
| Card dispute (chargeback) | When the bank withdraws the money the payment is reversed on the account; if the practice wins and Stripe reinstates the funds it is applied again. An inquiry moves nothing. The dispute fee is the practice's cost and is not posted to the patient. |
| Refund | Reverses the payment on the newest charges first, so the refunded amount is owed again and appears on the next statement. |