Nightly flows now match card settlements, insurer remittances, and cash entries from five branches against the practice ledger. Clean matches clear automatically and mismatches land on a short morning exception list — turning month-end close from a nine-day forensic project into one day.
Typical results
96%
Transactions auto-cleared
15 min
Morning exception review
5
Branches reconciled nightly
Figures reflect typical results for this kind of automation.
The challenge
Payments arrived from every direction — card processors, insurer remittances, cash drawers at five branches — and none of it matched the ledger without manual detective work. Month-end close swallowed nine days, insurer underpayments hid inside the noise for months, and the finance manager could never say with confidence what any branch actually earned.
Before and after
Month-end close
−89%Unmatched transactions per month
−91%Reconciliation work per week
−83%The automation
We built nightly Make flows that pull card settlements, insurer remittance files, and cash entries from all five branches and run a three-way match against the ledger — by amount, date, patient, and claim reference. Exact matches auto-clear and post; everything else lands on a morning exception list grouped by likely cause, from partial insurer payments to duplicate charges. A live dashboard shows each branch's reconciled revenue, and underpayments are flagged the day they arrive.
How it works
- 01
Nightly pull
After close, flows pull card settlements, insurer remittance files, and cash entries from every branch.
- 02
Three-way match
Each payment is matched to ledger entries by amount, date, patient, and claim reference.
- 03
Clean matches cleared
Exact matches auto-clear and post to the ledger without a human touch.
- 04
Exceptions triaged
Mismatches land on a short morning list, grouped by likely cause — partial payments, duplicates, missing claims.
- 05
Morning review
The bookkeeper works a fifteen-minute exception list, and month-end becomes a formality.
Starts from
- Card settlements
- Insurer remittances & cash
Delivers
- Auto-cleared matches
- Morning exception list
- Branch finance dashboard
The impact
Around 96% of transactions clear automatically overnight, and the bookkeeper's morning exception review takes about fifteen minutes. Month-end close drops from nine days to one, insurer underpayments are caught and disputed within days instead of quarters, and recovered shortfalls often cover the cost of the build early on.
Questions about this automation
How are payments matched to the ledger?
Every night after close, Make flows pull card settlements, insurer remittance files and cash entries from each branch. Each payment is compared with ledger entries by amount, date, patient and claim reference. Exact matches clear and post automatically, and anything that does not line up moves to the morning exception list.
What does the morning exception list show?
The list groups unmatched items by likely cause, such as partial insurer payments, duplicate charges or a claim with no matching payment. Each line shows the source records side by side, so the bookkeeper can resolve it quickly. Insurer underpayments are flagged on the day the remittance arrives so they can be disputed early.
Which systems need to be connected?
The flows need access to the card processor's settlement reports, insurer remittance files, each branch's cash records and the accounting ledger. A dashboard then reads the reconciled results per branch. Because it runs nightly across several sources, this is a multi-step build, usually rolled out in stages, often one branch at a time.