Medical Billing Reconciliation for Inpatient Specialists
Connect the claim, the payer response and the payment. DEVZ reconciles inpatient billing outcomes as part of an end-to-end service for Australian specialists, helping keep outstanding administrative work visible.
Know what happened after a claim was lodged
A submitted claim, a payer response and a bank deposit describe different stages of the billing cycle. Medical billing reconciliation brings the available information together so a specialist can understand which accounts have a documented outcome and which still need attention.
DEVZ Solutions includes reconciliation within its end-to-end inpatient billing service for Australian surgeons, anaesthetists, physicians, other specialists and locums. We manage this work in our own billing environment, following claims from preparation and lodgement through administrative follow-up and payment matching.
What we compare during reconciliation
Billing record
The authorised service information, billed amount and claim references establish what was submitted.
Claim outcome
Available processing responses identify assessed items, exceptions and matters requiring clarification.
Remittance information
Available remittance and authorised payment information help connect the payment to the relevant account.
The comparison is based on the evidence available for that claim. An unmatched amount should be investigated before it is treated as missing income, a duplicate payment or a final shortfall.
Medicare and private health fund reconciliation
Inpatient medical billing may involve Medicare, a private health insurer and different payment arrangements. It is useful to keep the claim reference, provider, episode and payer response connected so that a payment can be traced to the correct work.
DEVZ reviews the available claim and payment information, records the administrative position and follows up outstanding exceptions as appropriate. If a discrepancy depends on the original clinical information or fee instructions, we ask the practitioner to clarify those details before taking further action.
ECLIPSE reports and remittance advice
ECLIPSE offers different reports for transaction status, claim processing and applicable remittances. These reports serve different purposes: a processing outcome is not a substitute for checking the relevant payment information. Report availability depends on the transaction type, software and participating insurer.
DEVZ uses the information available through its own billing software and the agreed workflow. For the current report types and limitations, see the Services Australia processing and payment reports guidance.
How we handle unresolved items
- Identify the difference. We compare the billed account with the available response and remittance information.
- Check the administrative details. Claim references, provider details, dates and supplied billing information are reviewed.
- Confirm the next action. We seek missing information or practitioner authorisation where needed.
- Follow up appropriately. This may involve a payer enquiry, authorised correction or resubmission through an available pathway.
- Record the outcome. We keep the billing position clear, including items that remain unresolved.
Resubmitting a claim without understanding the existing response can create further confusion. Our rejected claim follow-up service deals with those administrative exceptions as part of the wider billing process.
Your income goes directly to your account
Medicare and private health fund payments go directly to your nominated bank account. DEVZ does not receive, hold or pool your medical income. Reconciliation uses the relevant reports and authorised information; it does not require routing your professional fees through a DEVZ bank account.
During onboarding we agree what payment information is needed and how it will be shared securely. Do not send bank statements containing patient information, patient lists or clinical records through public website forms, general email or WhatsApp.
Reconciliation within the DEVZ billing service
Our model is an end-to-end inpatient billing service using DEVZ’s own secure, Medicare- and ECLIPSE-compliant software. We do not remotely log into your existing practice software to provide an isolated reconciliation service.
If you have older claims in another system, tell us about the current workflow first. We need to assess the available records, access to relevant outcomes and suitability for an agreed transfer into DEVZ’s service. Historical payments or unresolved claims cannot be reliably matched without the necessary information.
Billing fees and getting started
The DEVZ fee is 3.5% of billings processed, plus GST, invoiced monthly. That is equivalent to 3.85% including GST. There are no per-claim charges and no lock-in contracts. A $0 setup fee applies where you are already registered and enabled for the relevant online billing arrangements; registration or onboarding assistance may incur a separate fee where required.
Start with a discussion about your specialty, approximate inpatient workload and current billing process. We can then agree the service scope and secure onboarding arrangements. Claim acceptance, payment timing and recovery of outstanding amounts remain subject to the payer’s requirements and the circumstances of each claim.
Frequently asked questions
Is reconciliation included in the DEVZ billing service?
Yes. Reconciliation forms part of DEVZ’s end-to-end inpatient billing administration, alongside claim preparation, lodgement and appropriate follow-up.
Do you reconcile claims inside my existing practice software?
No. DEVZ works in its own secure billing environment. We discuss the suitability of any historical billing before agreeing a transfer into the DEVZ service.
Does DEVZ receive my Medicare or health fund payments?
No. Payments go directly to your nominated bank account. DEVZ does not receive, hold or pool your medical income and invoices its service fee separately.
Does an unmatched payment mean the claim must be submitted again?
No. The claim response and available payment information need to be checked first. The appropriate next step depends on the actual records and payer requirements.
Let’s discuss your inpatient billing
Tell us about your practice and the administrative support you need. Please keep patient information out of your initial enquiry.
Contact DEVZ Solutions