How it runs for home care and home health agencies
Card accounts used for supplies and mileage are reconciled to receipts, and payroll clearing is tied to the Gusto or ADP register. Unexplained items are listed for you, never forced to balance.
What is a bank reconciliation service?
A bank reconciliation service compares the transactions in your accounting software with the transactions on your bank and credit-card statements and explains every difference. The goal is a ledger balance that agrees with the statement after timing items such as outstanding checks and deposits in transit. Done monthly, it catches missing entries, duplicates, bank errors and fraud early.
What we handle for home care and home health agencies
- Match MCO and Medicaid deposits to 835 remittances line by line
- Reconcile private-pay ACH and card receipts net of processor fees
- Tie the payroll clearing account to each Gusto or ADP register
- Reconcile supply and mileage card statements to receipts monthly
- List every unexplained deposit or withdrawal with an owner and a next step
The KPI that matters here
Zero unreconciled items older than 30 days across operating, payroll and card accounts.
Home care compliance notes
EVV
The 21st Century Cures Act requires electronic visit verification for Medicaid personal-care and home-health visits, captured through state aggregators such as HHAeXchange or Sandata. We bill only from verified visits and keep an exception log for visits that need a manual correction before they can be claimed.
HIPAA
Client names, diagnoses and authorizations are protected health information. We sign a BAA, our staff are HIPAA-trained, access is limited to the roles that need it, and PHI never appears in ledger memos or emailed spreadsheets.
State Medicaid and MCO rules
Each state waiver and each managed-care organization sets its own authorization limits, unit rounding, timely-filing window and recoupment process. We track authorizations against billed units and record recoupments as reductions to the original claim, not as unexplained bank debits.
FLSA Home Care Rule
Most agency caregivers are entitled to minimum wage and overtime, and travel time between clients counts. Your payroll provider computes the pay; we make sure the ledger and the labor-cost reports reflect it correctly and that live-in and sleep-time arrangements are coded as your counsel directs.
Home care software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- AxisCare
- WellSky
- Alora
- HHAeXchange
- All 50 platforms
More for home care and home health agencies
Other services for home care
Bank reconciliation in other industries
Frequently asked questions
Why does an MCO deposit rarely match a single invoice?
Managed-care organizations pay in batches and issue an 835 remittance listing every claim in the batch, with adjustments and denials. One deposit therefore covers many clients and dates of service. We match the deposit to the remittance total and then apply each line to its claim, so the bank agrees to the ledger and the aging reflects what was actually paid.
How do you handle processor fees on private-pay payments?
The gross payment is applied to the family's invoice and the processor fee is posted to a merchant-fee expense line. This keeps the receivable clear and shows the true cost of accepting cards. Monthly, we reconcile the processor's payout report to bank deposits so fee changes or held payouts are caught right away.
What happens to payments that belong to someone else?
Occasionally an LTC carrier or a state program pays your agency for a period a family already paid, or pays you for a client who has moved. We post those to a refunds-payable liability, not to revenue, and list them for your review with the refund address. That protects your P&L from overstated income and keeps your obligations visible.
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