Diagnostics & Pharmacy
Reconciliation for diagnostic chains, pharmacy retailers, and healthcare distributors
Reconciliation in Diagnostics & Pharmacy
Diagnostic chains and pharmacy retailers operate at the intersection of insurance, distribution, and direct retail — each with distinct payment flows. Insurance settlements (cashless and reimbursement) arrive via TPAs with TDS deductions; pharmaceutical purchases flow through distributors with trade scheme adjustments and credit notes; lab aggregators (1mg, Practo, Redcliffe) settle weekly with platform commissions deducted. A 50-centre diagnostic chain processes 8,000–20,000 insurance claims per month and purchases from 200+ pharma distributors — creating a multi-source reconciliation challenge that manual processes cannot sustainably manage.
Where reconciliation breaks down
These are the structural problems that generic tools cannot solve for Diagnostics & Pharmacy businesses.
Insurance TPA settlement matching
Cashless insurance payments arrive via TPAs in batch settlements that net off disallowances, co-pays, and TDS. Matching these batch credits to individual patient test records — with the correct deduction breakdown — requires disaggregation logic beyond standard accounting.
Distributor credit notes and trade schemes
Pharma distributors issue credit notes for expiry returns, rate differences, scheme discounts, and free goods. Reconciling outstanding payables against credit notes — especially when credit notes arrive weeks after the original purchase — creates a chronic accounts payable mismatch.
GST on pharmaceutical purchases
Pharma products attract GST at 5%, 12%, or 18% depending on the item. ITC on purchases must be reconciled against GSTR-2A/2B, with credit note GST reversals tracked separately. GST mismatches with distributors are a frequent cause of ITC rejection.
Lab aggregator platform settlements
Platforms like 1mg Labs, Practo Diagnostics, and Redcliffe settle weekly with commission and TDS deducted. Each platform uses a different settlement format and commission structure, requiring standardised ingestion before reconciliation can begin.
How TransactIG solves this
TransactIG is built by Terra Insight with diagnostics & pharmacy-specific configuration, not generic matching logic.
TPA settlement disaggregation
TransactIG matches TPA batch credits against individual test records using patient ID, claim number, and approved amount — with TDS and disallowances classified as named variance types.
Distributor credit note matching
Credit notes from distributors are matched against the original purchase invoices they reference, clearing the outstanding payable and flagging unmatched credits for follow-up.
Aggregator settlement reconciliation
Pre-built ingestion templates for 1mg, Practo, and Redcliffe handle weekly settlements, commission deductions, and TDS — producing a matched record per test booking.
Reconciliation patterns
Configuration presets
No custom development
These presets are included with every Diagnostics & Pharmacy deployment of TransactIG. Go live in 2–4 weeks.
Frequently asked questions
How does TransactIG handle insurance TPA rejections and partial payments?
Rejected claims are classified as a named variance type (query raised, partial approval, or full rejection) with the original claim reference retained for re-submission follow-up.
Can TransactIG reconcile purchases from 200 distributors simultaneously?
Yes. TransactIG supports unlimited vendor reconciliation within a single instance, with per-distributor outstanding reports and credit note matching.
We have both B2B (corporate) and B2C (direct patient) billing. Can TransactIG handle both?
Yes. Corporate billing (invoices with TDS) and direct patient collections (cash, UPI, gateway) are handled with separate matching rules in the same instance.
Does TransactIG support GST reconciliation for pharma businesses with both taxable and exempt supplies?
Yes. TransactIG supports mixed-supply GST scenarios, tracking ITC eligibility separately for taxable inputs used in taxable vs exempt supplies.
Ready to automate Diagnostics & Pharmacy reconciliation?
Terra Insight will walk you through a live TransactIG demo using diagnostics & pharmacy transaction data — matching patterns, variance taxonomy, and ERP integration.