Match Submitted Claims Against EOBs, Remittances, and Contracted Rates Automatically
Reconciling claims means checking what was billed against what was paid, line by line, against the contract. Kosh AI handles all of it as remittances come in.
A payment only means something once it's tied back to the exact claim and procedure it was meant to settle.
A small gap on one claim looks minor. Across a month of volume, it adds up to real revenue.
A payer collapsing two billed codes into one lower-paying line looks like a small adjustment. It isn't.
A paper EOB and an ERA for the same claim can both get posted, quietly inflating receivables.
An underpayment that's never appealed is a write-off by default, whether or not anyone decided it should be.
Four steps that take a remittance from arrival to a fully reconciled, actioned claim.
Claims reconciliation needs differ by practice size, specialty, and how claims are actually billed.
Checking paid amounts against contracted fee schedules across every payer the practice bills.
Keeping reconciliation consistent across locations that may bill under different contracts.
Reconciling claims across many client practices without a separate manual process for each one.
Catching underpayments and denials in time to appeal before filing deadlines close.
Confirming that posted receivables actually reflect contracted reimbursement, not assumed payment.
Spotting recurring underpayment or denial patterns worth raising directly with a specific payer.
Practices where a manual check still mostly works, but misses the small, repeated underpayments.
Claim volumes where manual line-by-line review simply isn't realistic anymore.
Teams scaling past the point where a spreadsheet-based reconciliation process keeps up.
Every remittance is checked against the contracted rate, not just the ones that look obviously wrong.
Variances surface while there's still time left in the filing window, not after it closes.
A paper EOB and an ERA for the same claim never both inflate the books.
Recurring denials or bundling by a specific payer become visible instead of handled one claim at a time.
Remittances match to claims automatically, so billers spend time on variances, not routine posting.
Every match, variance, and resolution is logged as it happens, not rebuilt from memory later.
Kosh AI connects directly with all major banks and ERPs, enabling real-time data sync for faster, more accurate reconciliations—no manual uploads, no delays.
Spotting a real underpayment takes more than a line-item comparison. Kosh AI understands which variances are routine and which ones are worth appealing.
Learns which payers and procedure codes generate recurring underpayments, surfacing the pattern instead of one claim at a time.
Identifies when a payer has substituted or bundled billed codes, even when the remittance doesn't say so directly.
Surfaces the variances closest to their filing deadline first, so nothing expires simply because it was found late.
Catches a paper EOB and ERA for the same claim before both get posted and inflate receivables.
A claims reconciliation tool checks that what a practice billed matches what the payer actually paid, using the EOB or electronic remittance advice (ERA, often delivered as an 835 file) as the source of truth. It matches each remittance line to its open claim by claim number, procedure code, date of service, and patient ID, then compares the paid amount against the contracted rate.
Done manually, this means a biller cross-referencing EOBs against claims one at a time, usually catching only the underpayments that look obviously wrong. A $70 gap on a single procedure is easy to miss, but across a month of claim volume, those small gaps compound into real lost revenue, especially when the appeal window closes before anyone notices.
Kosh AI's claims reconciliation tool matches remittances to claims automatically as they arrive, flags underpayments, denials, and bundling against the contracted rate, and tracks filing deadlines so a flagged variance gets appealed in time instead of written off by default.
Checking EOBs against claims one at a time can work for a small practice. See what changes once reconciliation runs automatically.
| Feature | Automated Claims Reconciliation | Manual Claims Reconciliation |
|---|---|---|
| Remittance Matching | Matched automatically by claim number and procedure code. | Cross-referenced by hand, claim by claim. |
| Underpayment Detection | Checked against the contracted rate for every line. | Usually only catches gaps that look obviously wrong. |
| Duplicate Remittances | Flagged before posting. | Can be posted twice, inflating receivables. |
| Denial & Bundling Review | Identified and routed automatically. | Often requires a biller to notice the pattern manually. |
| Deadline Tracking | Filing windows tracked against every flagged item. | Easy to miss once a variance sits unresolved. |
| Audit Trail | Built automatically as claims are reconciled. | Reconstructed from EOBs and notes before a review. |
Manual claims reconciliation tends to catch only what's obviously wrong. A biller scanning an EOB can spot a flat denial easily enough, but a $70 underpayment on a single crown, buried in a line item, is the kind of gap that gets missed every time, and missed gaps don't stay small. Across a month of claim volume, they compound into real, recoverable revenue that never gets recovered.
The bigger risk isn't any single underpayment, it's the filing deadline attached to it. Once the appeal window closes, that revenue is written off by default, whether or not anyone actually decided to accept the loss. A reconciliation process that only catches variances during a monthly batch review is working against its own clock.
Kosh AI's claims reconciliation tool checks every remittance against the contracted rate as it arrives, not in a periodic sweep, and tracks the filing deadline attached to each flagged variance. That means underpayments, denials, and bundling surface with enough time left to actually do something about them.
Claims reconciliation stops being a quick manual task in a few common scenarios.
Past a certain volume, checking each remittance against the contracted rate by hand stops being realistic.
Different contracted rates across payers make manual comparison error-prone at any real scale.
Reconciling several practices' claims manually every cycle doesn't scale past a handful of clients.
Any practice that keeps finding the same payer underpaying needs a tool that surfaces the pattern automatically.
A few habits keep claims reconciliation fast enough to matter before filing deadlines close.
Bring a recent batch of remittances to the call. We'll show you how Kosh AI would have flagged the underpayments automatically.
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