Three systems, three answers to the same question
The record system says the practice made the value of the appointments it checked out last month. The point of sale says what was rung up, including retail, tips and tax. The bank shows what landed after the processor took its fee and held the chargebacks. Three honest answers to three different questions, and the owner reads whichever one is on screen as revenue. The report is wrong because nobody has decided which question it answers, not because anyone is careless.
The five places the report lies
- Refunds and chargebacks land in the wrong month. The sale is in March, the refund is in April, and March stays inflated unless somebody moves it.
- Prepaid credit, packages and gift cards are counted when sold instead of when used. The practice looks like it had a strong December and a quiet February, and the treatment happened in February. Whether prepaid money is revenue or a liability on your books is a question for your accountant, and the answer changes the report.
- Provider attribution splits the consult from the treatment. Dana does the consult, a second provider does the treatment three weeks later, and one of them shows as carrying the patient while the other shows as idle.
- Discounts hide inside line items. A neurotoxin visit rung up at a reduced price looks like fewer units sold, not a discount given, and the discount total never appears anywhere.
- Retail, tips and sales tax sit inside the service number on some exports and outside it on others, so month over month compares two different definitions.
Where each source lies, and the check that catches it
| Source | What it is good for | Where it lies | The check |
|---|---|---|---|
| Record system | Who was treated, by whom, for what, and when | Prepaid credit at the sale, discounts inside the line, refunds in the month they were processed | Tie checked-out appointments to the point of sale, patient by patient, for one week |
| Point of sale | What was rung up and how it was paid | Retail, tips and tax mixed into services; voids and refunds that never reach the record | Total by payment type and compare to the processor's batch for the same days |
| Payment processor | What was charged, refunded and charged back, by day | Fees netted out; chargebacks weeks after the sale; batches that cross a month end | Match each daily batch to a bank deposit; the unmatched ones are the story |
| Bank | What the practice can spend | Nothing about what was sold; one deposit covers several days; refunds appear as debits with no patient name | Tie every deposit to a batch, and every debit to a refund or a fee |
The monthly reconciliation: four sources, one sheet
- Export four things on the first business day of the month: completed appointments from the record system and the sales report from the point of sale. Then the processor's batch and refund report, and the bank statement.
- Put them on one sheet, one tab each, with the month in the file name.
- Reconcile top down. Record to point of sale: what was treated against what was rung up. Point of sale to processor: what was rung up against what was charged. Processor to bank: what was charged against what landed.
- Write every difference on a fifth tab with a reason: refund, chargeback, gift card redeemed, package used, discount, tip, tax, timing. A difference without a reason is next month's first job.
- Agree the number with your accountant once, in writing: what counts as revenue, when prepaid money counts, and where discounts show. Then the sheet runs the same way every month.
How to do this Monday
- Pull last month's four exports before the first appointment.
- Reconcile the record system to the point of sale for one week only. The gap you find in a week is the gap in the month.
- List the prepaid balances outstanding: packages, memberships, gift cards. Ask your accountant how they want them treated, and write the answer down.
- Ask Priya at the front desk to add a discount reason to every reduced-price checkout from today, so next month's discount total exists.
What a clean number changes
Every decision in the practice sits on the revenue number. Revenue by provider decides who gets the new patients and what a raise is worth. Revenue per bookable hour tells you whether to add a room. The ad budget comes from cost per new patient, and the choice between the comeback and the ads comes from returning versus new. If the number underneath is inflated by prepaid money or deflated by a refund in the wrong month, every one of those decisions inherits the error. The owner finds out two quarters later, when the bank balance disagrees with the dashboard. Strategy starts after the number is clean, not before.
What to do next
NorthCore's Know your numbers solution builds this reconciliation into the live dashboard from the exports you give it, with refunds, prepaid credit and discounts on their own lines. Scoped in writing and covered by the promise on this site: results in 90 days, or we keep working until you have them.
