Reconciliation of payments and outstanding balances

Purpose

1.1. Automate reconciliation of payments received from patients or insurance against outstanding invoices for home health care services.
1.2. Automatedly detect mismatches and overdue payments.
1.3. Process insurance claim payments and patient co-pays automatically, updating the financial records to reflect the status.
1.4. Automator workflows log, match, and flag discrepancies to accounting, reducing manual input and human error.
1.5. Automated notifications for finance/accounting for unresolved or delinquent balances, improving follow-up timelines.

Trigger Conditions

2.1. New payment entry in accounting, billing, or bank feed software.
2.2. Invoice marked as “sent” or “due” in billing platform.
2.3. Update from insurance EOB/API reflecting payment, rejection, or partial application.
2.4. Automated daily/weekly batch reconciliation trigger.
2.5. Manual override trigger for exceptions or flagged mismatches.

Platform Variants

3.1. QuickBooks Online
- API: Payments endpoint; automated invoice/payment matching configuration for healthcare clients.
3.2. Xero
- API: Bank Transactions & Invoices API; schedule to automate reconciliation batches.
3.3. Sage Intacct
- API: AR & Cash Management APIs; automate balance mapping & variance reporting.
3.4. Stripe
- Feature: Events API - listen for successful payments; automated hook to update home health care billing records.
3.5. PayPal
- API: Transaction Search API; automate extraction and matching of received payments with issued invoices.
3.6. Square
- API: Payments API; automatedly fetch daily payments and trigger reconciliation routines.
3.7. Zoho Books
- API: Invoices & Payments API; automate syncing and matching outstanding balances.
3.8. FreshBooks
- API: Payments Events Hook; trigger automation when payments cleared for health care invoices.
3.9. Salesforce Health Cloud
- API: Billing Module; automate update of account status after payment events.
3.10. Microsoft Dynamics 365 Business Central
- API: Financials Endpoints; automate ledger entry update and balance verification.
3.11. Kareo
- API: Payment Reconciliation API; automate claims payment receipt and posting.
3.12. Athenahealth
- API: Payment Posting; automate EOB reading and outstanding matching in health care scenarios.
3.13. AdvancedMD
- API: ERA (Electronic Remittance Advice) Automation; triggers on incoming insurance payment packets.
3.14. Medisoft
- API: Billing and Payment Automation Routine; extracts daily balances and automates reconciliation.
3.15. Cerner
- HL7 Interface: Automatedly collects payment and claim outcomes for matching.
3.16. Epic Systems
- Bridges Integration: automates balance posting and alerts for unmatched payments.
3.17. Wave Accounting
- Webhooks: Payment received triggers, automates ledger update for home care businesses.
3.18. RCM Automator (Revenue Cycle Management)
- Payments Module: Batch reconciling claims and patient payments, exception reporting.
3.19. Bill.com
- API: Automated invoice/payment matching; triggers on payment confirmation updates.
3.20. Netsuite
- SuiteTalk (SOAP/REST API): automate financial transaction mapping and reconciling routines.

Benefits

4.1. Automates repetitive matching, saving finance/admin labor hours.
4.2. Automated reconciliation improves billing accuracy and collection speed.
4.3. Automating reminders and exception handling reduces aged receivables.
4.4. Automation increases transparency and reporting for audits or compliance.
4.5. Automator reduces payment posting delays and patient confusion.
4.6. Automatedly tracks performance, providing actionable data for scaling home care operations.