Month end, three labs, one practice manager
At the start of the month the lab statements arrive. One is a PDF with forty lines, another is a portal download, the third is a paper invoice in the post. Each line has a docket number, a patient surname, an item and a price. Somewhere in the practice, the practice manager sits down with the lab book, the associate list and a spreadsheet, and works out which clinician each line belongs to.
It matters because in many practices lab fees are shared with associates or deducted from their pay under their contract, and because private items may be passed on to the patient. Get it wrong and someone is paid incorrectly or a patient is overcharged.
Why the numbers never line up first time
- Labs identify cases by their own docket number, which your system does not store.
- Patient names are spelled differently, or a child is under a parent's name.
- Remakes appear as a second line, sometimes charged and sometimes not.
- An item is invoiced in one month but the fit happens in the next.
- A case sent by a locum has no obvious owner.
None of these is hard to resolve for a single line. Together, across several labs, they turn a routine task into a day.
What it costs to do by hand
The direct cost is the practice manager's time at the busiest point of the month. The indirect costs are worse: associate statements delayed while lab fees are checked, disputes when an associate queries a deduction and nobody can show the case it relates to, and remake charges paid without anyone noticing that the lab usually covers them.
There is a quieter cost as well. When the matching is rushed, lines that do not fit are often just accepted to get the job finished, so the practice pays for items it cannot trace to a patient. Nobody is being careless; there is simply no time at month end to argue with a lab about a single docket from six weeks ago.
The reconciliation we put in place
- Lab statements are collected from a shared inbox or a folder, whichever the labs already send to.
- Each statement is read line by line. PDFs and scans are extracted with a document model and checked against the totals printed on the statement, so a misread is caught.
- Every line is matched to a lab case using docket number where the case tracker holds it, and patient name, date and item where it does not.
- Matched lines are assigned to the treating clinician and flagged NHS or private, following the case record.
- Duplicates, possible remakes and lines with no matching case go to an exception list with the likely candidates shown, for a person to decide.
- The result is exported in the form your accountant or associate pay process needs, for example a CSV for Xero or a summary per associate.
| Line on statement | What the system does |
|---|---|
| Docket matches a case | Assigned automatically |
| Name and date match, docket unknown | Suggested match for a person to confirm |
| Same item twice for one patient | Flagged as possible remake or duplicate |
| No case found | Exception with nearest candidates |
| Statement total differs from lines | Whole statement held for checking |
The split rules (for example what share of a lab bill an associate carries) come from your contracts. We apply them as written and do not interpret them.
Month end without the matching session
Most lines arrive already matched. The practice manager reviews a short list of exceptions, approves, and the associate summaries and the accounts export are ready. When an associate asks about a deduction, the case, the docket and the statement line are one click apart.
Over time the exception list is also a record of which labs invoice cleanly and which do not.
Does this sound like your month end?
- Lab statements are matched to associates in a spreadsheet.
- Associates query lab deductions and the evidence is hard to find.
- You are not sure whether remakes are being charged.
- Associate pay statements wait until lab bills are sorted.