Status: Delivered. Described from our own delivery records. Client identity, brand and commercial terms are withheld. Figures, where given, cover the period stated and nothing beyond it.
Context
A revenue-cycle operation whose payment records must agree with those held by the hospital facilities it serves.
Where they disagree, money is either not collected, not credited, or credited twice — and the disagreement does not announce itself.
The problem
- Discrepancies were found only when someone reconciled manually, which was slow and error-prone in itself.
- Different facilities operated on different cadences, so one reconciliation routine did not fit them all.
- By the time a difference surfaced, the window to resolve it had often narrowed.
- The revenue effect was real but unquantified, because nobody was counting what was being missed.
What we built
Automated reconciliation flows for twelve client facilities
Each running on the cadence appropriate to that facility rather than a single group schedule.
Six categories of discrepancy detected automatically
Each raised with the records that produced it rather than as a bare exception count.
Scheduled distribution of findings
To the stakeholders responsible for resolving them.
How we delivered it
- 1
Define what a discrepancy is
Six categories, agreed with finance and operations before any code was written. This is the step that determines whether the output is trusted.
- 2
Build per-facility flows
Since the data shape and cadence differ.
- 3
Run silently for a period
Comparing automated findings against manual reconciliation.
- 4
Turn on distribution
Once the false-positive rate was acceptable to the people who would receive it.
- 5
Add new facilities to the pattern
As they onboard.
How it was phased
Indicative phasing for work of this shape. Actual duration varies with data quality, access and decision speed.
What the client keeps
- The reconciliation flows and their source
- The discrepancy definitions as documentation
- Per-facility configuration
- The distribution routing