Healthcare Business Books Cleanup The batch and the day sheet

Two reports, one month

The day sheet says who was seen and what was charged. The bank says what arrived. An insurer often pays a batch, not a single encounter, and the batch can cover last month's visits as easily as this month's. A card processor sends a net amount. The fee it kept never appears in the deposit, which is why a clinic that books the deposit as income is quietly booking a smaller practice than the day sheet describes.

Pick a rule and keep it. Encounters stay on the day they happened, and the batch that arrives later is a collection of amounts you already recorded. Or, if the clinic truly records only when cash arrives, every encounter waits until the cash arrives, including the ones the insurer has not paid. Mixing the two rules inside one month counts some visits twice and drops others. The relief people feel when the bank "matches" is not the same as a month that is closed.

We tie the bank, the cards, and any loan or line the clinic uses before we call the month finished. A feed that imports on its own is a convenience. It is not a reconciliation. Someone still has to say the ending balance on the statement is the ending balance in the books, and to list what is still outstanding.

Fees, refunds, and money that is not revenue

A processor fee is a cost. A refund to a patient is a reduction of what was charged, or a return of cash, and it has to point at the original charge when the papers allow it. An owner's transfer from a personal account is not patient revenue. Posting that transfer as visits makes the month look busy and makes the return start from the wrong income.

When a deposit cannot yet be named, it waits on the balance sheet. The waiting line is the open-items list. It leaves only when a document supports one of the four exits: an ordinary cost, an owner transfer, a movement between two companies the owner has, or a real account that was missing (a card, a loan, a second bank). We do not clear the waiting line because the calendar says the month should be done.

What to bring

Bring the day sheet for one month, the deposits for that month, and the processor report that shows the fee. If the insurer's batch covers more than one month, bring the explanation of benefits or the remittance that lists the encounters. We can say, from those papers, whether the books are using one rule. We cannot say it from the bank balance alone.

The statements that come out of a closed month are useful only after this tie. A profit figure built on deposits, with the fee still buried and the shelf still inside the visit, is a smooth number. It is not a number you should plan from.

Keep going.