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Once a month, the practice’s three records get forced to agree: what the PM system says you earned, what the remittances say you were paid, and what the bank says arrived.

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The checklist

Post every remittance: no unposted 835s or paper EOBs left in the queue. Match every deposit to a remittance (reconciliation), chasing the two classic orphans: deposits with no ERA (ERA enrollment gap, fix in the payer directory) and ERAs with no deposit (payment went to an old account, see switch banks). Match processor batches: card settlements minus fees tie to the PM’s patient payments (POS). Reconcile each bank account in the bookkeeping file, book payroll and the loan split (principal vs. interest), fund the tax reserve, and in multi-entity structures confirm the management fee was invoiced and paid. Then review AR aging and push the worst balances into the denial workflow or patient follow-up.

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The output

A closed month: P&L and balance sheet you trust, and the KPI sheet filled from real numbers. Half a day for a solo practice once the routine exists; the first close is the slow one.