Revenue cycle reconciliation
Billing and finance teams cannot explain differences between encounters, coded services, and remittances.
The challenge behind the workflow.
Billing and finance teams cannot explain differences between encounters, coded services, and remittances.
Connect operational and research data with clear purpose, provenance, and access. Help teams prepare reliable evidence for service planning, quality review, research, and administration while keeping clinical judgment with qualified professionals.
Data to bring together
- Encounter administration
- Billing records
- Remittance events
Source systems are examples of the data required. Confirm connector availability, permitted access, refresh timing, and the authoritative owner before implementation.
How Genedata supports the work.
Configure one connected workflow, then reuse its mappings, definitions, and review process as the business grows.
- 01
Connect and prepare
Link services to billing and payment references while retaining adjustment history.
Build the preparation as a reusable visual workflow or reviewed code, with explicit source mappings and validation checks. - 02
Investigate and validate
Identify unmatched records and incomplete administrative evidence.
Keep shared definitions and source versions with the analysis so another team can reproduce the result. - 03
Publish and review
Publish a reconciliation queue with source links and accountable owners.
Make the output available to the right people with appropriate access, ownership, and review evidence.
A revenue cycle reconciliation queue
Make the next run easier.
Shared service-to-payment models reduce repetitive searches across billing systems.
Start from one approved example. Save the agreed mappings and definitions, publish the reviewed output, and let the next team follow the same evidence instead of rebuilding the preparation.
Measure your own improvement
Age of unresolved revenue cycle exceptions
Record a baseline before the pilot and compare like-for-like work afterward. Results depend on source quality, configuration, and adoption.Review and responsibility
Authorized specialists validate coding and payer requirements before resubmission.
AI with professional judgment.
Use AI to organize evidence and draft summaries for review. Clinical interpretation, patient care, and research eligibility decisions remain with qualified professionals.
Try the workflow with your team.
Use representative, approved sample data. Agree the expected output and a review owner before extending the workflow to a live process.