LTSS Billing Reconciliation & Units Tracking Tool

Turning Manual Billing Audits Into an Automated Reconciliation Workflow

Project Overview

Project Overview

Are your billing teams still cross-checking claims against service logs by hand — hunting line by line for missing documentation, duplicate claims, and hours discrepancies? At HillsEditor Services, we build automation tools that catch these issues before they become compliance problems, turning a manual audit process into a fast, repeatable workflow.

This tool was built around a real LTSS Maryland billing workflow and validated against a real 294-row Maryland DDA Monthly Authorized Service export — correctly surfacing 3 critical-threshold accounts, 1 source-flagged exception, and 5 billed-vs-entered discrepancies. It ships with fully synthetic sample data, so it can be demonstrated without exposing any real client or member information.

Approach & Benefits

How the Process Works

LTSS Billing Reconciliation and Units Tracking Tool overview graphic showing three steps: automated reconciliation, color-coded reporting, and units tracking dashboard

Automated Claims-to-Log Reconciliation

  • Cross-checks every billing claim against subcontractor service logs automatically
  • Flags missing documentation, duplicate claims, and hours discrepancies
  • Surfaces unbilled services so no revenue is left on the table
  • Removes hours of manual, line-by-line auditing

Color-Coded, Audit-Ready Reporting

  • Outputs a single Excel workbook with Summary, Discrepancies, and Verified tabs
  • Issues sorted worst-first and color-coded by severity (red / amber / blue)
  • Flat table format, ready for direct upload to a SharePoint document library
  • Creates a clean audit trail for every claim reviewed

Real-Time Units Tracking Dashboard

  • Browser-based tracking app built with Streamlit
  • Flags authorized service-unit balances per client as OK / Watch / Critical
  • Surfaces Billed-vs-Entered mismatches and source-flagged exceptions automatically
  • Prepares a review-ready table for manual submission — no automated portal access, ever; a human reviews and submits everything

Ideal For

  • LTSS and waiver-program billing coordinators
  • Subcontractor and service-validation teams
  • Healthcare operations and compliance staff
  • Any organization reconciling claims against service documentation at scale

Let's Automate Your Reconciliation Workflow

If your team is still auditing billing claims by hand, we can help you build a tool that does the first pass automatically — flagging what needs a human look and clearing what doesn't.

Get in touch →

Why Organizations Choose Automated Billing Reconciliation

  • Hours saved on manual, line-by-line claim audits
  • Billing errors caught before submission, not after
  • Clear, color-coded audit trail for every claim
  • SharePoint-ready output — no reformatting required
  • Built with strict data-handling boundaries: no automated submissions, human review required at every step
  • Adaptable to other billing and service-validation workflows beyond LTSS