Medical Billing Reconciliation

What this service delivers

Medical Billing Reconciliation provides systematic verification that all revenue your practice has earned is actually being collected. Each month, we reconcile your billing records against insurance payments and patient payments, identifying gaps where expected revenue hasn't arrived and determining why.

You'll receive detailed reports showing which claims are outstanding, how long they've been pending, and what patterns exist in your collection processes. This visibility helps you understand not just what you're collecting but what might be slipping through gaps in the billing cycle.

The outcome is confidence that your practice is capturing the revenue it earns. You'll know which insurance payers are slow, which claim types require extra attention, and where your billing processes might benefit from adjustment. This translates directly to improved cash flow and reduced revenue leakage.

The revenue challenge in healthcare

Healthcare practices deal with revenue collection complexity that most businesses never encounter. Insurance companies process claims on varying timelines, sometimes taking weeks or months to pay. Patient responsibility portions aren't always clear at the time of service. Claims can be denied for technical reasons that have nothing to do with whether care was appropriate or necessary.

Without systematic reconciliation, it's surprisingly easy for revenue to go uncollected. A denied claim that doesn't get resubmitted, an insurance payment that's less than expected but not questioned, patient balances that age without follow-up. These small gaps add up to meaningful amounts over time, affecting your practice's financial stability without being immediately obvious.

Many practitioners suspect they're not collecting everything they should but don't have clear visibility into where the gaps are or how significant they might be. This uncertainty makes it difficult to know whether revenue issues reflect normal variation or indicate problems that need addressing.

How we approach reconciliation

Our medical billing reconciliation process starts with matching each billing record against actual payments received. We track claims from submission through payment, identifying where expected revenue hasn't arrived and determining the cause. Insurance underpayments, denied claims, and uncollected patient balances all get flagged for review and follow-up.

We maintain aging reports for outstanding claims, categorizing them by payer and time pending so you can see where collection efforts need focus. Patterns in denials or payment delays get highlighted in monthly reports, helping you understand whether issues are isolated incidents or systematic problems that warrant attention.

This approach is effective because it combines detailed transaction-level matching with broader pattern analysis. You get both the specific information needed to follow up on individual claims and the context to understand your overall revenue cycle performance. The result is actionable insight rather than just data.

What working together looks like

When you begin medical billing reconciliation service, we'll connect with your billing system to access claim submissions and payment records. This initial setup lets us establish baseline data about your current outstanding claims and typical collection patterns. We'll review this baseline with you to ensure we're aligned on what normal looks like for your practice.

Each month, you'll receive reconciliation reports showing new claims submitted, payments received, outstanding balances by age, and any discrepancies that need attention. We identify specific claims requiring follow-up and provide the information you need to pursue them effectively. If patterns suggest systematic issues with particular payers or claim types, we'll highlight these for discussion.

You'll experience relief from the uncertainty about whether your revenue is being fully captured. Questions about specific claims can be answered quickly because we maintain current reconciliation data. Over time, you'll develop a clearer sense of your actual collection patterns and where your revenue cycle performs well or needs improvement.

Investment and what's included

Medical Billing Reconciliation is offered at $2,200 per month. This investment provides comprehensive revenue verification for your practice, ensuring that the care you deliver translates fully into the revenue you collect.

Your monthly service includes:

Complete reconciliation of billing records against insurance payments, identifying discrepancies and missing revenue
Aging reports for outstanding claims organized by payer, claim type, and time pending
Pattern analysis showing collection trends, common denial reasons, and payer payment behaviors
Patient balance tracking with aging categories to support your collection efforts
Identification of underpayments where insurance reimbursement is less than expected contracted rates
Monthly reconciliation reports highlighting priority claims for follow-up action
Documentation supporting claim appeals or resubmissions when appropriate
Direct communication about reconciliation findings and recommended follow-up actions

This monthly investment provides both financial value through recovered revenue and peace of mind through knowing your collections are being monitored systematically. Many practices find that improved revenue capture more than covers the cost of reconciliation service.

Measuring reconciliation effectiveness

The effectiveness of medical billing reconciliation shows up in several measurable ways. Most immediately, you'll see specific claims and revenue amounts that were previously unknown or overlooked, representing direct recovery opportunities. The first reconciliation report often identifies revenue that can be pursued through claim resubmissions or payer follow-up.

Over subsequent months, you'll develop clearer visibility into your collection patterns. The percentage of claims collecting within expected timeframes, the consistency of reimbursement rates from different payers, and the effectiveness of your denial management processes all become visible through ongoing reconciliation data.

Timeline for results varies based on how current your billing processes are when starting service. Practices with significant backlogs often see meaningful revenue recovery within the first two months as aged claims get identified and pursued. Those with more current billing typically see value through pattern recognition and process improvements over a three to six month period.

Our commitment to you

We're confident in the value medical billing reconciliation provides because we've seen how it transforms revenue visibility for healthcare practices. Our commitment is to deliver thorough, systematic reconciliation that genuinely helps you capture the revenue your practice earns.

If after the first two months you're not seeing meaningful value in the reconciliation reports or the revenue opportunities we've identified, we'll discuss adjusting our approach or transitioning you to a different solution. We want you working with us because the service delivers real benefit, not because you feel obligated to continue.

Before committing to monthly service, we offer an initial consultation to review your current billing situation and discuss what reconciliation might reveal for your practice. This conversation helps both of us determine whether this service would provide meaningful value for your specific circumstances.

Getting started is straightforward

Beginning medical billing reconciliation involves connecting with your billing system to access claim and payment data. We'll coordinate this integration to minimize disruption to your current workflows. The initial setup typically takes about a week, during which we establish baseline data about your outstanding claims and collection patterns.

Your first reconciliation report will be delivered within two weeks of starting service, showing current outstanding claims, identified discrepancies, and initial observations about your collection patterns. Subsequent reports follow on a monthly schedule, with ongoing reconciliation happening continuously in the background.

The main thing that might affect your start timeline is the condition of your current billing data. If records need significant cleanup before reconciliation can be meaningful, we'll identify this during the initial review and can discuss whether that cleanup should happen before beginning monthly service.

Ready to explore this together?

If you'd like to discuss how medical billing reconciliation might improve your practice's revenue capture, we'd be happy to have that conversation. Share your information below and we'll reach out to schedule a time that works for you.

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