Payment Posting → GL Guide
A practical bridge from remittance activity to accounting treatment. Pick a posting scenario to see a generic journal-entry example, or scan the full mapping below. Examples use generic account names — review them with your controller, auditor, or CPA.
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Data statusReference Only
- Status
- Reference Only
- Data year / effective
- General revenue-cycle practice
- Last reviewed
- May 2026
- Last updated
- May 2026
- Primary source
- General revenue-cycle accounting practice (generic accounts)
- Formula notes
- Maps common remittance line items (payment, contractual, patient responsibility, sequestration, recoupment, interest, refund, write-off, reversal, credit balance, unapplied cash, bad debt) to illustrative journal entries.
- Known exclusions
- Educational examples using generic account names
- Chart-of-accounts and contra-revenue vs expense treatment vary by organization
- Recoupment and credit-balance handling differ by policy
Educational examples, not accounting advice. Review with your controller, auditor, or CPA before adopting.
Scenario → journal entry
How remittance maps to the GL
Typical treatment for the line items you see on an 835 / ERA. Account names are illustrative.
| Remittance item | Usual treatment |
|---|---|
| Payer payment received | Debit Cash, credit Medicare A/R |
| Contractual adjustment (CO) | Debit Contractual Allowance, credit A/R |
| Patient responsibility (PR) | Transfer A/R: debit Patient A/R, credit Medicare A/R |
| Sequestration | Debit Contractual Allowance (sequestration), credit A/R |
| Recoupment / takeback | Reinstate A/R or use a Recoupment Receivable; credit Cash |
| Interest payment | Debit Cash, credit Interest Income |
| Refund to payer | Debit Refund Payable / Overpayment, credit Cash |
| Denial / write-off | Debit Contractual Allowance or Write-off, credit A/R |
| Reversal / correction | Reverse the original entry, then re-post the corrected adjudication |
| Credit balance | Debit A/R, credit Refund Payable (credit-balance liability) |
| Unapplied cash | Debit Cash, credit Unapplied Cash; clear when posted |
| Bad debt | Debit Bad Debt Expense, credit Patient A/R |
Related
General revenue-cycle accounting practice. Not a substitute for your organization's accounting policy or professional advice.