Bank & credit-card reconciliation for medical practices & clinics

Bank reconciliation for medical practices & clinics starts with the deposit report from Kareo/Tebra or AdvancedMD, because a bank deposit rarely equals one claim. A single line may combine a Medicare EFT covering 200 claims, a payer's virtual card payment net of a processing fee, and a patient portal batch. We reconcile operating, payroll, refund and reserve accounts monthly, match each deposit to an ERA batch, a lockbox or a patient payment batch, and post processor and virtual-card fees separately.

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How it runs for medical practices and clinics

Credit-card accounts used for supplies are reconciled to receipts, payroll clearing is tied to the register, and unexplained items are listed rather than plugged.

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 medical practices and clinics

  • Match each deposit to an ERA batch, lockbox report or patient payment batch
  • Post virtual-card and processor fees separately from the gross payer payment
  • Reconcile refund and patient-credit accounts to the refund register monthly
  • Tie payroll clearing to the Gusto or ADP register every pay period
  • List unexplained deposits or withdrawals with a suggested action for the administrator

The KPI that matters here

Zero unreconciled items older than 30 days across operating, refund, payroll and card accounts.

Medical practices compliance notes

HIPAA

Claims, remittances and patient statements are protected health information. We sign a BAA, staff are HIPAA-trained, access to your practice-management system is role-limited with MFA, and ledger entries carry claim or batch numbers rather than patient names or diagnoses.

Payer rules and timely filing

Every payer contract sets timely-filing limits, appeal windows, coordination-of-benefits rules and refund procedures. Medicare allows 12 months from the date of service to file; many commercial payers allow less. We log deadlines per payer so unpaid claims are worked before they age out.

Overpayment refunds

Identified Medicare and Medicaid overpayments must be reported and returned within 60 days of identification under the Affordable Care Act. We age credit balances by payer, prepare refund batches for your approval, and document the dates so the practice can show it acted in time.

Patient credit balances and unclaimed property

Patient overpayments that go unrefunded may become reportable unclaimed property under state law after a dormancy period. We list patient credits monthly, prepare refunds for your approval, and keep records that support any state filing your counsel advises.

Medical practices software we work in

More for medical practices and clinics

Frequently asked questions

Why should a payer's virtual card payment be recorded differently?

Some payers pay by virtual credit card instead of EFT, and the practice's processor deducts a fee when the card is run. The ERA shows the gross amount while the bank shows the net. We record the gross against the claims, the fee to merchant expense, and match the net to the deposit. Many practices can opt out of virtual cards; that is your decision to make with the payer.

How do you reconcile patient portal payments?

The portal or card processor deposits patient payments in batches, net of fees, a day or two after the patient pays. We match each batch to the patient payment report in the practice-management system, post the fee separately, and confirm the net agrees with the bank. Refunds issued through the processor are matched to the refund register so they are not double-counted.

What if a deposit cannot be matched to anything?

It is posted to a suspense account with a note and listed for the administrator, not left as income. Common causes are a payer paying a claim that was written off, a patient paying a balance twice, or an ERA that arrived before the deposit. Each is resolved within the month, and anything still open at close appears on the exception list with its amount.

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