Tying posted payments to bank deposits is what makes every other number trustworthy, and it is the step most often skipped. Without it, unposted recoupments, missing remittances and posting errors stay invisible in every claim-level report you run.
Practices close their books. Fewer close their revenue cycle, and the difference is why so many reports are approximately right.
The step that matters most
Reconciling posted payments to bank deposits. Every payment recorded should tie to money actually received, and every deposit should be explained by posted payments.
When they do not agree, the causes are informative: unposted remittances, recoupments taken as offsets, payments posted to the wrong account, or deposits from a source nobody expected. Each is a real problem, and none is visible in a claim-level report.
The rest of the close
- Confirm all remittances are posted, including paper ones and any portal-only payers.
- Review credit balances and categorize them, because the refund clock runs from identification.
- Review write-offs by category, particularly the timely-filing bucket, which is pure process failure.
- Age the A/R by date of service and flag anything approaching a filing deadline.
- Produce the six metrics, segmented by payer.
Why it gets skipped
It produces no immediate revenue and nothing breaks visibly when it is missed. The consequences are gradual: reports drift from reality, recoupments hide inside soft months, and credit balances age past their window.
The question worth asking your biller
Do you reconcile posted payments to our bank deposits monthly, and can I see it? If the answer is no, every number they report is an estimate — internally consistent, and not necessarily connected to your bank account.
Lock the period
If postings can be backdated after the close, the numbers you reported change quietly and last month’s report stops matching this month’s starting point.
Close the period in the system and require an adjustment entry for anything after. It makes the trail visible instead of silently rewriting history.
Review credit balances every month
Credit balances accumulate from overpayments, duplicate payments and posting errors, and they are a compliance obligation rather than a bookkeeping nuisance — refunds to payers and patients have deadlines attached.
Left to accumulate, they also overstate collections and understate A/R at the same time.
Ask the question your biller may not expect
"Do you reconcile to our bank statement, and can I see last month’s?" Many billing arrangements report claim activity in detail and never compare it to money received.
If the answer is no, that gap is where recoupments and missing remittances live, and nobody currently owns it.
Common questions
- What is month-end close in a medical practice?
- Reconciling posted payments to bank deposits, confirming all remittances are posted, reviewing credit balances and aged A/R, and locking the period so the numbers stop moving.
- Why reconcile payments to bank deposits?
- Because it is the only step that catches money that never got posted — offsets, missing remittances, deposits split across postings. Claim-level reports cannot see any of it.
- What happens if you skip reconciliation?
- Every downstream number becomes approximate. Collections look wrong with no explanation, and recoupments sit undiscovered past their appeal deadline.
- How long should month-end close take?
- A day or two for most practices once it is routine. It takes far longer the first time, because the first close surfaces everything the previous months missed.
- What should I ask my billing company about close?
- Whether they reconcile to your bank statement, who reviews it, and what they do with unposted differences. Many report on claims only and never touch the bank.
Denials Piling Up?
We handle the revenue cycle end to end — coding by certified coders, claim submission, denial management and appeals, and A/R follow-up, with six reported numbers every month.