Billing Reconciliation
Every group bill matched to enrollment and payroll each month, every variance explained before it ages.
Why it matters
Self-billed and list-billed cases drift every month: new hires, terminations, salary changes and retro elections leave variances nobody has time to explain.
How the solution handles it
Agents read each bill and remittance, match every member to enrollment, recheck rates, volumes and age bands, and give each variance a reason. Credits and retro changes are drafted. A billing specialist approves every adjustment.
How a bill moves
Five agents read, match, recheck rates and volumes, explain variances and draft adjustments; a billing specialist approves every change.
What it reads, and what it hands back.
What goes in
- Self-bills and list bills
- Enrollment and eligibility records
- Rate and age-band tables
- Payments and remittances
What comes out
- Reconciled bill
- Variance list with reasons
- Retro adjustment drafts
- Aged-variance report
Who uses it
The difference, in numbers.
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“Target” = design goal, measured in the live solution · “Estimated” = our estimate · by-hand time from an 8-hour working day · agents = the live solution’s configuration
5 specialist agents. One person decides.
More in this division.
Every broker RFP and census becomes a clean, quote-ready case the same day, every gap flagged.
Enrollment & EOIEvery enrollment matched to the plan, and every amount above guaranteed issue held for EOI review.
Disability ClaimsEvery disability claim built, cited and decided well inside the 45-day ERISA clock.
Build this
for your team.
We’ll show Billing Reconciliation running on your own documents.