Site payment reconciliation, step by step

Most research sites know their study revenue looks lower than it should, but cannot point to where it went. Reconciliation answers that question with evidence rather than suspicion.

The method below works for one study or an entire portfolio, and needs nothing more than the executed budget, the EDC and your bank records.

Step 1: Rebuild the payment schedule from the executed budget

Start with the agreement that was actually signed, including any amendments. List every payable item: per-visit amounts, screening and screen failure payments, startup and closeout fees, invoiceables, pass-through costs, and the holdback percentage. This list is what the sponsor owes under the contract. Anything not on it will never be paid, and anything on it that was missed is recoverable.

Step 2: Pull the completed activity from EDC

Export the visits completed for each subject, with dates and status. Include screen failures and early terminations, because they are commonly forgotten in payment but explicitly payable in most budgets. A visit that exists in EDC and matches the budget is earned revenue, whether or not it has been invoiced.

Match on the same key

Reconciliation fails when two lists cannot be compared. Use subject number plus visit name as the key on both sides. If the sponsor's remittance uses different visit labels, map them once and keep the mapping.

Step 3: Line up payments received

Take the remittance advices and bank receipts and allocate each payment to the visits it covers. Three patterns appear almost every time:

• Visits completed but never paid. Often from a single cycle where data was entered late or a query was open at cut-off.
• Visits paid at the wrong rate. Usually an amendment that raised rates but was never applied.
• Invoiceables never billed. Screen failures and unscheduled visits are the most common, because they fall outside the automatic visit payment.

Step 4: Build a discrepancy log

For every difference, record the subject, the visit, the contractual amount, the amount received, the difference, and the evidence. This log is the entire negotiation with the sponsor. A claim supported by a visit date, an EDC record and a budget line is difficult to refuse. A claim that says "we think we are short" is easy to refuse.

Step 5: Raise and chase the claims

Group the claims by cause rather than sending them subject by subject. One clear message covering all screen failure payments is more effective than ten separate emails. Track each item to resolution, with a date for the next follow-up. Most recoveries are lost to silence, not refusal.

Step 6: Do not forget the closeout

Holdbacks are released at closeout, and only if someone asks. Before a study closes, confirm:

• The holdback has been released in full.
• Final invoiceables, including record retention and closeout visits, have been billed.
• Any pass-through costs paid by the site have been reimbursed.
• The final reconciliation has been agreed in writing with the sponsor.

How often to run it

Monthly is ideal for an enrolling study, because discrepancies are easiest to resolve while the cycle is fresh. Quarterly is workable. Once a year turns reconciliation into archaeology, since the people who could explain a payment have often moved on.

What good reconciliation gives a site

• Confidence that every visit performed has been paid at the agreed rate.
• Evidence for disputes, instead of an argument.
• A clear view of each study's profitability, which informs which studies to take next.
• Clean records for your accountant, your auditors and your tax filings.

Reconciliation is not an accounting formality. For a research site it is the difference between the revenue a study promised and the revenue it actually delivered.

Talk to us about your study if you would like this handled for you, or read more about our sponsor services and research site services.