Documents

The reconciliation requires a carrier invoice and a benefit census. Additional documents enable additional analyses.

⬆

Drop files here CSV, XLSX, XLS, PDF · invoice exports, census exports, rate sheets, deduction registers

Analysis coverage0%

Weighted by the dollar value of the analyses each document enables. The reconciliation requires the invoice and the census.

Required input files

A sample of each of the two required inputs. Synthetic sample data, generated by the RRECKTEK Synthetic Data Agent.

Optional documents

Beyond the two required inputs. Ordered by the dollar value of the analyses each one enables. Each entry includes a sample and downloadable files in three formats.

Harlowe Provisioning Inc. — Group 0319-6204

Billing period October 2026 · 3 carrier invoice files (BCBSM) · census 474 election rows / 164 employees · synthetic sample run

Total billed

$89,602

current charges, 3 sub-groups

Overbilled

recoverable / month

Underbilled

$680.96

exposure / month · $8,171 / yr

Lines matched

48 / 48

55 exact, 1 normalized

Unaudited

enrollees, no invoice file

Core reconciliation

SAMPLE

Member	Plan	Tier billed	Tier per census	Billed / mo	Entitled / mo	Delta / mo	Annualized	Finding	Match
Pemberton, Everett	PPO 1250	Single	Employee + 1	$523.18	$1,167.36	−$680.96	−$8,171.52	Tier mismatch	Exact
Garcia Lopez, Paloma	PPO 1250	Family	Family	$1,703.40	$1,703.40	$0.00	$0.00	Clean	Normalized
54 further lines reconciled with no variance								Clean	Exact
HSA Value 2750	—	—	37 enrollees	—	—	—	—	Unaudited — no invoice	—

To extend this section: add the HSA Value 2750 invoice file. 37 enrollees are currently outside the audit.

Name resolution

SAMPLE GLiNER + rule veto

Records are joined on normalized last and first name. Where the carrier sends a PDF or a scanned statement there are no columns, so subscriber names are extracted with GLiNER (urchade/gliner_medium-v2.1, zero-shot, 384-token sliding window) and the rule set determines identity. Measured on this group's PDF statement:

Span lifted from PDF	NER score	Census key	Similarity	Disposition
Pemberton, Everett T.	0.92	Pemberton Everett	1.000	Subscriber · matched
Garcia Lopez, Paloma	0.88	Navarro-Quintana Paloma	1.000	Subscriber · matched
Adebayo, Tunde	0.84	Adebayo Tunde	1.000	Subscriber · matched
Thornbury, Marisol R.	0.86	Thornbury Marisol	1.000	Subscriber · matched
A. Adesanya, MD	0.71	—	0.364	Provider · suppressed

Worked example

On this run, 47 of 48 invoice lines matched the census exactly by name. The 56th was Garcia Lopez on the statement against Navarro-Quintana in the census; character-level similarity resolves it at 1.000. The treating physician is detected and then excluded by the credential rule, so a provider is not reconciled as a member.

Identity veto

Two records carrying different values of a discriminating identifier (SSN, DOB, MEMBER_ID, MRN) are treated as different people regardless of other agreement. Dates are canonicalized first, so 01/13/2009 and 2009-01-13 compare equal. The rule separates records; it does not merge them.

Not used for: coverage tier, plan code and contract number. Those fields are read by the rule set.

Dependent aging out

NEEDS DOC

Dependent detail not provided Add dependent dates of birth and relationship codes to flag children aged 26 or older and price the tier downgrade available. Vendor-published ineligible rates run 3–10% at $4,344–$7,000 per dependent per year.

Payroll deduction verification

NEEDS DOC

Deduction register not provided Add per-pay employee contributions and pay frequency. The engine multiplies to a monthly figure and compares it against the employee share of premium, splitting the result into over-deducted and under-deducted with annualized deltas.

ACA affordability (4980H(b))

NEEDS DOC

Compensation data not provided Add annual salary or hourly rate to test every full-time employee against the W-2, rate-of-pay and federal-poverty-line safe harbors. 2026 penalties are $3,340 under 4980H(a) and $5,010 under 4980H(b), per employee per year.

Tier vs household

PARTIAL

Runs on the census alone. One member is billed above recorded household composition; see the reconciliation table. Married co-worker detection, where two single contracts cost less than one family contract, requires the dependent cross-reference.

To extend this section: add dependent detail to complete the household comparison.

Analyses available as documents arrive

Analysis	Unlocked by	Produces	Status