National health insurance billing reports on paid and rejected services, private insurer notices, pre-invoices and supplier invoices arrive by email and as scans, and administrators retype and reconcile them by hand. The solution extracts amounts, identifiers and service codes, reconciles them with bookings in Cliniko or CGM and posts them to accounting, and the administrator approves the mismatches.
Built for ISO 27001NIS2 DORA
A clinic's administration receives a daily stream of documents that have to be not only recorded but reconciled: billing reports on services paid and rejected by the national health insurance fund, notices from private insurers, pre-invoices to patients, supplier invoices for medication and supplies. Each insurer sends its own format, often a PDF or a scanned table, and in the billing exports the service codes, patient identifiers and amounts have to match what was provided and booked in Cliniko or CGM. Manual reconciliation takes days, mismatches are noticed at the end of the month, and the deadlines for correcting or appealing rejected services are sometimes missed.
The solution watches an agreed mailbox, a scan folder and a folder of billing exports. Document recognition pulls tables and text out of PDFs, photos and scanned files, and a private model in the MDP CLOUD GPU cloud in Lithuania (EU) determines the document type and sender and extracts the lines: the patient identifier, the service code and date, the amount, and the decision of the insurer or the national health insurance fund. Each line is then reconciled with the bookings and services provided in Cliniko or CGM, and supplier invoices with purchase orders. Documents that match are posted to the accounting system, for example SAP Business One, through its import or interface with all required details. Mismatches (a different amount, a service not found in the clinic system, an unclear identifier, a rejection by the fund or insurer) go to the administrator's list with an explanation of what the agent found and the deadline for reacting. The administrator decides each case and approves it, and only then does the entry appear in accounting; corrections in the billing system or in Cliniko or CGM are made by a person, not by the agent. We connect to Cliniko and CGM through an API, a file export or an email flow, depending on the version, and use billing data only from the reports you export; we choose the method after checking. Patient data stays in the EU and is not used to train the model, every document and decision is logged for GDPR, and the accounting interface works with a separate technical user and limited permissions. If you keep your books in SAP Business One, we use the ERP hosting integration: ERP hosting.
Four steps from input to a record in your system, with human approval wherever there is risk.
A billing report, a private insurer notice, a pre-invoice or a supplier invoice arrives by email, is scanned into a folder or is exported from the billing system to an agreed location. The solution recognises the type and sender, extracts tables and text, and immediately returns an illegible document to the administrator.
A private model in the EU extracts the lines into patient identifier, service code, date and amount, and reconciles them with the bookings and services provided in Cliniko or CGM. Supplier invoices are compared with purchase orders and earlier prices.
Fully matching documents are posted to the accounting system, for example SAP Business One, through an import or an interface with all required details and the attachment. Mismatches are shown to the administrator with the agent's explanation and a suggested action, and the entry appears only after approval. Corrections in the billing system or the clinic system are made by a person.
Services rejected by the national health insurance fund or an insurer, taken from billing reports and notices, are collected in a separate list with the reason and the deadline, so administration has time to correct or appeal. We add new insurer formats, monitor reconciliation accuracy and maintain the private environment and the interfaces with Cliniko or CGM and accounting.
Processing of PDFs, scanned files, billing exports and photos in a private environment in the EU, with profiles for national health insurance fund reports, each of your insurers and your main suppliers.
Matching logic between billing reports and insurer notices, bookings and services provided in Cliniko or CGM, with the permitted deviations set by your finance lead.
A window for mismatches and rejections with explanations, deadlines and one-click approval, available in Teams or the browser.
Entries into SAP Business One or another accounting system through an import or an interface, read-only integration with Cliniko or CGM through an API or an export, a full document and decision log for GDPR, and our support.
Document recognition in a private environment in the EU + billing exports and insurer notices, reconciliation with Cliniko or CGM through an API, an export or an email flow, and entries into SAP Business One or another accounting system through an import or an interface, depending on the version. We choose the platform by the task and by where your data may be located; read more about this service and its limits on the service page.
No. Documents are processed by a private model in the MDP CLOUD GPU cloud in Lithuania (EU), in an environment dedicated to your practice. Data stays in the EU, is not used to train the model, and only the fields needed for the entry are passed to the accounting system.
We use billing data from the reports you export; the agent does not connect to the national health insurance billing system itself and writes nothing there. We reconcile with Cliniko and CGM through an API, a file export or an email flow, depending on the version, and write to SAP Business One or another accounting system through an import or an interface. We choose the integration method after checking; a first solution with the billing reports, two or three insurers and one accounting system is usually launched within 2–4 weeks.
A rejection, with the stated reason, from a billing report or an insurer notice goes into a separate list with a deadline to respond. The administrator decides whether to correct the entry in Cliniko or CGM, appeal, or move the amount to the patient, and the agent can prepare a draft reply to the insurer. Corrections in the systems are made only by a person.
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