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Version: 1.0.0
Last Updated: 2026-02-19
Spec: PM-09 Payment Posting & ERA Processing
Constitution Reference: Section 1.2 (Core Independence), Section 1.3 (Integration Patterns)

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Overview

PM-09 owns payment posting (insurance ERA/835 and patient payments), CARC/RARC adjustments, denial routing, write-off/bad debt with approval, and integration with FA core for GL revenue posting.

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Integration Points (from spec)

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Event Contracts (PM-09 → FA)

Pattern: Event-based. PM-09 publishes to cl_pm_events; FA subscribes for GL posting.
  • PM-08: Payment applications reference pm_claims and pm_claim_lines; implementation posts payments and updates claim status (paid, partial_payment, denied).
  • PM-15: ERA file ingestion (upload or webhook from clearinghouse); document exact trigger and file retrieval in implementation plan.
  • PM-12: Statement data exposed for patient portal; document API or data contract when PM-12 is implemented.
  • FA: Revenue and write-off posting via events only. Contract: EVENT_CONTRACTS.md – PM-09 → FA (payment_posted, write_off_approved). PM-09 (or PF-10 for write-off) publishes payment_posted and write_off_approved; FA consumes and posts to GL. Idempotency by event_id.

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Integration Matrix

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References