Prerequisites
- Payments posted daily
- Read access to each entity’s bank account
- Processor settlement reports
- 835s retrievable from your clearinghouse
The three-way match
All three must agree. Where they don’t, the difference must be explained, not plugged.The 15-minute daily checklist
1
Close yesterday's day sheet and total the posted payments
Separate payer and patient payments. Within patient collections, distinguish checkout payments, treatment-plan deposits, payment-plan installments, and membership charges so each flow can be traced.
2
Total the 835s received
Claim payments plus or minus PLB adjustments. The PLB is what makes remittance totals differ from claim-payment sums.
3
Total deposits into each PC's operating account
Payer EFTs, card settlements, and check deposits.
4
Match EFTs to 835s by TRN
Reconcile by the TRN reassociation trace number, not by dollar amount. Amount-matching works until two payers send similar amounts on the same day, then it produces silently wrong postings. The TRN is carried in the 835 and in the EFT’s ACH addenda record specifically so this match is deterministic.
5
Explain every difference
The legitimate ones:
Anything you cannot explain is an error. Find it today, while the transaction is one day old.
6
Check for unexpected debits
Payers can pull money out. A dental payer with an ACH debit authorization can recoup an overpayment directly from the PC’s account. In a multi-entity group with no cross-entity view, an unexplained debit can sit for weeks. Scan for them daily. See Handle recoupments.
7
Confirm each entity's money landed in that entity's account
Per PC. A misconfigured EFT enrollment routing one entity’s payments to another is a commingling problem, and per-entity reconciliation is the only thing that catches it.
Card settlement mechanics
Cards reconcile differently and trip people up:- Batch settlement: a day’s transactions settle as one deposit, so individual payments do not appear separately
- Net of fees: the deposit equals gross transactions less processing fees
- T+1 or T+2: the deposit arrives one or two days after the transaction
- Refunds and chargebacks reduce settlements, sometimes in a later batch
Returned deposits
A deposited check can be returned days later, reversing the credit and usually charging a fee. Common reasons include insufficient funds, closed account, stop payment, and stale dating. Run a returned-item review as part of the daily check. If you posted the payment on deposit, your ledger is now wrong, and in a dental support organization (DSO) group a returned deposit can cascade into a management fee transfer that shouldn’t have been made. See Payment rails 101.Multi-entity reconciliation
Reconcile each entity every business day. Confirm whether the bank provides a consolidated view across legal entities or requires separate access for each account. Practical mitigations:- Consistent account naming so a long list is scannable
- Read-only access for the person reconciling, across every entity
- A single reconciliation template parameterized by entity, rather than one per entity
- Bank or platform reporting that surfaces ACH addenda data, so TRN matching can be automated
Verify it worked
- Day sheet closed daily and tied to the bank, per entity
- EFTs matched to 835s by TRN
- Every difference explained, none plugged
- PLB adjustments identified and recorded
- Card settlements reconciled; gross revenue and fees recorded separately
- Unexpected debits scanned for daily
- Returned items reviewed
- Each entity’s payments confirmed landing in that entity’s account