A LEDGER FOR CLINICAL PRACTICE · VOL. I

From hello
to banked.

Reconcilium is a private, practice-grade ledger that follows every clinical encounter from the patient's first hello to the moment the money clears your bank — every consultation, procedure, invoice, remittance and receipt, auditable to the cent.

Daybook · sample folio
FOLIO 142 — 05.IV.MMXXVI
DATE PATIENT PROCEDURE BANKED STATE
014205 IVMr T. RadebeRight THR · GEMSR 32 410.50Banked
014103 IVMrs K. MasangoAnkle arthroscopyLodged
014002 IVMr J. Du PlessisBipolar hip · rightR 28 940.20Banked
013901 IVMs Z. MhlongoConsultation · newR 1 185.00Banked
013801 IVMr F. VenterHip dislocation · MUAHello
5 ENTRIES · APR MMXXVI
Banked this folio R 62 535.70
A private ledger for clinicians Every hello, every hand-shake, every cent Consultations · Procedures · Remittances · Receipts Surgery-date truth, reconciled to the bank Offline. Local. Yours. A private ledger for clinicians Every hello, every hand-shake, every cent Consultations · Procedures · Remittances · Receipts Surgery-date truth, reconciled to the bank Offline. Local. Yours.
I.
THE GAP

A busy practice leaks money — quietly, and almost always.

Between the theatre slate and the bank statement, there are ten hand-offs. A procedure is coded, an invoice lodged, a remittance issued, a deposit made under a reference that looks nothing like the patient's name. It adds up.

28%
of invoiced fees that an unreconciled practice typically writes off each year — silently.
11days
median lag between a GEMS remittance landing and the matching deposit appearing — across two statements and three tranches.
0refs
bank narration that matches the patient's surname. Reconciliation is ninety percent reading between lines.
II.
THE METHOD

Five movements, from the first hello to the last rand.

Each encounter advances through a short, well-worn sequence. No step is skipped; every step leaves a mark on the ledger.

MVT. 01

Hello

i
The encounter is logged the instant the patient is seen — consultation, theatre slate or ward round. Nothing is left to memory.
MVT. 02

Scribe

ƒ
Clinical note, ICD-10 code, procedure code and fee schedule are captured against the encounter with structured precision.
MVT. 03

Lodge

§
The invoice is issued to the medical scheme. Reconcilium watches for ERAs, authorisations and claim states in the background.
MVT. 04

Reconcile

Remittance advice and bank deposit are matched against the originating case — including partial payments, assistant fees and clawbacks.
MVT. 05

Banked

The ledger row is closed, the patient file is marked settled, and the earnings roll up to your month and year totals.
§
III.
CAPABILITIES

Built for the real shape of a medical practice.

Every feature earns its place. No enterprise bloat, no cloud dependencies, no SaaS taxonomy that doesn't belong in a consulting room.

§

Encounter-first architecture

The patient encounter — not the invoice — is the unit of truth. Every document, payment and note attaches to the case it belongs to.

ERA & bank matching, hand-made

Drag in a Discovery ERA, a GEMS remittance, a bank statement CSV. Reconcilium resolves references, splits tranches and flags mismatches to the cent.

Assistant fees tracked

The day you assisted Dr Chivers is as accountable as the day you led. JBSAF codes, self-billing exceptions, all of it.

Funder intelligence

GEMS, Discovery, Medshield, Momentum, Bonitas. Know which schemes pay, which delay, which short-pay — quarter by quarter.

Private. Local. Yours.

Runs on your own machine. Your patient ledger never touches a third-party server. Export, back up, or migrate at will.

A ledger your accountant will love, and your colleagues will ask about

Reconcilium produces year-end summaries, funder-mix reports and case-level audit trails that satisfy SARS, your bookkeeper, and your own standards — in the same calm, typeset language.

THE HAND BEHIND IT
I built it for myself, first. Six years of billing, three data losses, and one very close miss of a hundred-thousand-rand tranche convinced me that a surgeon who cannot read his own bank statement against his own theatre book is not running a practice — he is running a hope.
The clinician behind Reconcilium · Orthopaedic Surgeon
R RECONCILIUM · VOL. I · MMXXVI
A workshop of one.
IV.
EARLY ACCESS

A small cohort of practices, this winter.

Reconcilium is being opened to a handful of South African clinicians for the Q3 2026 cohort — orthopaedic, surgical and specialist practices running their own billing. No enterprise sales, no onboarding fee.

Quiet correspondence.

Reconcilium opens to a small cohort of South African specialist practices this winter. Onboarding is personal, by introduction. If you keep your own billing and want to see the tool in motion, write in — briefly, with a line about your practice.

hello@reconcilium.co
Cohort size12 practices
OnboardingPersonal
Data residencyYour machine
OpensJuly MMXXVI
V.
FREQUENTLY ASKED

Small print, plainly set.

Is this a replacement for my billing system?

No. Reconcilium sits alongside your billing system — GoodX, Elixir Live, Altron HealthTech, whatever you use — and gives you the second set of eyes that practices almost always lack: the ledger that reads your bank statement back against your theatre book.

Where does my data live?

On your machine. Reconcilium is a locally hosted application. Your patient names, bank statements and remittances never leave your device unless you explicitly export them.

Does it handle consultations, or only surgery?

Both. Every chargeable encounter — a ward round, an in-rooms consult, a theatre case — is treated as a first-class ledger entry with its own reconciliation state.

What about assistant-surgeon work?

First-class support. Both the days you led and the days you assisted (JBSAF codes, Dr Chivers lists, self-billing arrangements) are tracked distinctly, so your fee reconciliation is never ambiguous.

Is it built on the Operations Tracker?

Yes. Reconcilium is the next-generation of the Operations Tracker that's been running in my own practice since 2020 — now extended to every clinical encounter, not just surgery.

Who is this not for?

Hospital-scale billing departments with enterprise RCM needs. Reconcilium is for the private practice that runs its own books and wants them to be watertight.