What is bank reconciliation in healthcare?
Bank reconciliation matches every deposit in the bank account to the remittance or payment it came from, so the money posted in the billing system equals the money actually received.
Bank reconciliation, 03/20/2026
| Deposit | Amount | Matched to | Status |
|---|---|---|---|
| ACH, Example Health Plan | $111.22 | 835, trace 1004821 | Reconciled |
| ACH, Sample Medicare | $4,812.40 | 835, trace 7730194 | Reconciled |
| Card processor payout | $1,163.50 | 38 patient payments, $1,198.00, less $34.50 fees | Reconciled |
| ACH, Example Marketplace | $1,946.00 | No 835 yet | Waiting, day 2 of 3 |
| 835, Sample Medicaid | $622.15 | No deposit found | Ask the payer |
- Card payouts are matched gross: the payments in full, and the processor's fees as a separate expense.
The billing system says what was posted. The bank says what arrived. Reconciliation proves they agree, deposit by deposit, and finds the money that’s missing, misposted or never posted.
What gets matched
- Payer EFTs to ERAs, by the trace number on both.
- Paper checks to EOBs, often through a lockbox.
- Card processor payouts to patient payments, with fees, refunds and chargebacks shown separately.
What it catches
Deposits with no remittance, remittances with no deposit, payments posted twice, recoupments nobody posted, and payments meant for another provider. Done daily, each is a small item. Done at month-end, they’re a pile.
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