Seven checks, once a month, about an hour: uninvoiced appointments, draft invoices, aged receivables, claims and third-party invoices with no outcome, cancellation fees, rate settings, and a diary-versus-takings sanity check. Every one of them uses reports already in your practice software, and every one of them exists because it catches money that leaks in real clinics.
Most allied health practices reconcile eventually - at tax time, or when the accountant asks a question nobody can answer. The problem with eventually is that billing errors get harder to fix as they age: patients move on, referrals expire, and claim lodgement windows close. A monthly rhythm keeps every problem young enough to fix. Here's the routine, in the order that finds the most money first. (For the deeper once-a-quarter version, see our practice billing audit guide.)
1. Uninvoiced appointments
Run your software's uninvoiced appointments report for the month just ended - in Cliniko that's a built-in report, in Zanda it's an Activity report filter (step-by-step for both: Cliniko / Zanda). Every completed appointment with no invoice is either an explainable exception or unbilled work. Name which, line by line - this is reliably the biggest leak in the list.
2. Draft and unfinalised invoices
A draft invoice collects exactly as much money as no invoice. Filter for drafts, finalise or delete each one, and note who they belonged to - drafts cluster around the same few workflows (usually a practitioner who invoices later, then doesn't).
3. Aged receivables
Pull outstanding invoices and sort by age, oldest first. Anything past your payment terms gets a follow-up this week - research on invoice payment behaviour is blunt that the odds of payment fall as invoices age (the numbers are in our revenue leakage research post). If the same payers appear every month, the fix is structural - see why unpaid invoices pile up - not another round of reminders.
4. Claims and third-party invoices with no outcome
Payment-by-someone-else is where money goes quiet: a Medicare claim that bounced, an NDIS payment request that was rejected, a health-fund or WorkCover invoice that simply never came back. List everything submitted to a third party last month that has no recorded outcome, and chase the silence - a rejection at least tells you what to fix (our guide to rejected Medicare claims and unpaid NDIS invoices covers the common causes). Note the deadlines here: bulk-billed Medicare claims for services from 5 September 2025 onwards must be lodged within one year of the service, and NDIS payment requests are expected within 90 days. Silence has an expiry date.
5. Cancellation and non-attendance fees
Compare last month's cancelled and did-not-arrive appointments against invoices raised. If your policy says a late cancellation is chargeable, every uncharged one is a policy that exists on paper only - and practitioners quietly waiving fees is a conversation to have with data, not suspicion.
6. Rates and item numbers
Five minutes: do your billable items still match the current schedules? NDIS pricing changes every July (the 2026-27 changes moved psychology up $20 an hour - a practice still billing last year's rate donates that to nobody), Medicare item numbers update, and your own fees drift. A rate set wrong once bills wrong every day until someone looks.
7. Diary versus takings
Finally, the sanity check: roughly, does the month's appointment volume times your average fee resemble the month's invoicing? A gap of a few percent is life. A gap of ten percent means one of the six checks above missed something - go back and find it.
Make it a habit, or make it automatic
Booked as a recurring hour on the first Friday of the month, this routine keeps most leaks small. The honest limitation is that it's monthly and human: it depends on someone having the hour, and it sees problems only when they're up to four weeks old. That's the gap RIFT exists to close - it runs these checks against your Cliniko or Zanda billing data continuously, flags each leak while it's still recent, and drafts the follow-ups. The first leak report is free and covers your last 12 months, which is also a fast way to find out what your current end-of-month routine has been missing.