How to identify underpaid and missing care fees
AI-generated illustrative photo. The interface and figures shown are fictional.
A payment has arrived, but does it cover the care fees you expected? For a care-home finance team, the useful question is not just how much reached the bank. It is which resident, funding source and care period each payment relates to.
A simple reconciliation process helps you separate a genuine shortfall from a timing difference or an allocation that needs correcting. Here is a practical way to work through it.
1. Start with a reliable expected-fees record
Choose the care home and reporting period you want to review. For each resident reference, record the agreed fee, the dates it applies to, the responsible payer and any funding split. Keep supporting fee agreements, rate changes and placement updates available to the people carrying out the review.
Check admissions, departures, temporary absences and changes in funding against the relevant agreement. A weekly rate multiplied by the wrong number of days can create a difference before any payment has been received.
2. Compare the same care period
Do not assume that a payment received this month pays for this month's care. Check the period shown on the remittance advice and the payer's payment schedule. Calendar months, four-weekly periods, adjustments and arrears can produce different totals.
Payment processes also vary between funders. Birmingham City Council, for example, describes scheduled payments for care-home placements without requiring an invoice. Use the process and dates agreed with your own payer rather than assuming every organisation follows the same rules.
3. Match the bank receipt to the remittance detail
A bank entry can cover several residents, periods or care homes. Match its reference and total to the remittance, then allocate the individual lines to your expected-fees records. Check for split payments, deductions, credits and duplicate entries before deciding that a fee is missing.
Keep an unmatched payment visible until you can identify it. Money that has arrived but has not yet been allocated should not disappear from the reconciliation. Equally, a remittance does not always mean the money has already cleared: NHS Shared Business Services explains that remittance advice can be generated when a payment is released.
4. Separate the differences that need attention
Use clear review categories so your team can decide the next action:
Matched: the payment allocated to the record agrees with the expected amount for the period.
Underpaid: the allocated payment is lower than expected and the difference needs checking.
No payment identified: no matching payment has been found for the record. Check the due date, remittance and unallocated receipts before treating it as overdue.
Overpaid or unmatched: an excess or unidentified amount needs investigation and correct allocation.
These are starting points for review, not proof that a payer has made an error. Confirm the underlying agreement, dates and adjustments first.
A simple example
Suppose an agreed fee is £1,000 a week for a four-week period. The expected amount is £4,000. A remittance allocates £3,750 to that same resident reference and period, leaving £250 to review.
Before contacting the payer, check whether an agreed adjustment, a changed start date or a separate payment explains the £250. If none does, record the difference and raise a focused query. These figures are fictional and are included only to illustrate the process.
5. Keep a clear follow-up record
For each unresolved difference, record the resident reference, care home, payer, care period, expected amount, allocated payment and remaining difference. Add the evidence checked, who is following up, the last contact date and the next action.
Use your organisation's approved secure channel when sharing supporting records. Send only the information needed to resolve the query. When a correction or payment arrives, update the record and check the revised balance rather than closing the query on a verbal assurance alone.
6. Make reconciliation a regular routine
Review new remittances and receipts regularly, then revisit unresolved items at each financial-period close. Keep a separate view of underpayments, records with no payment identified and unallocated receipts. This makes it easier to see what still needs a decision and avoids chasing the same item twice.
How CareOps Payments supports the review
CareOps Payments brings expected care fees, payments received and reconciliation differences into one workflow. Teams can process remittance files by care home and funding source, review matched and unmatched batch records, and use gap analysis and resident or financial-period reports to focus their follow-up.
It gives the people reviewing care fees a clearer starting point. Your team still checks the source records, confirms the reason for a difference and agrees the next action with the payer.
Book a CareOps demonstration to see the Payments workflow with your team.
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