Healthcare Practices
Bookkeeping for practices where you provide care today and find out what you'll actually get paid for it two months later.
The Industry
You see 30 patients this week and bill $45,000. Insurance will pay $28,000 of that after contractual adjustments, but not for another 60 days. Patient co-pays and balances add up to $8,000, half of which will never be collected. The practice provided the care. What you’ll actually receive for it is a different number that arrives on a different timeline.
Healthcare revenue doesn’t work like other businesses. You deliver services today and get paid months later at amounts lower than what you billed. Insurance contracts dictate reimbursement rates. Claims get denied or delayed. Patient balances sit unpaid. The gap between what the practice bills and what it collects is where cash flow gets squeezed.
Who This Covers
Who This Covers
Medical clinics, dental offices, chiropractic practices, optometry, mental health providers, physical therapy, speech therapy, veterinary practices. Any healthcare business billing insurance or managing patient accounts.
What Makes It Different
What Makes It Different
Revenue that’s uncertain until insurance processes the claim. Contractual adjustments that reduce billed amounts by 30% or more. Patient balances that require collection effort. Payroll for clinical staff with different certifications and rates. Cash that lags services by 60 to 90 days while overhead keeps coming due.
What We Handle
Monthly bookkeeping with revenue that reflects what you’ll actually collect, not what you billed. Contractual adjustments recorded so your P&L shows real practice performance. Insurance receivables aged by payer so you can see which claims are outstanding and for how long. Patient balances tracked separately with realistic write-offs when collection becomes unlikely.
Payroll for clinical and administrative staff with Ohio withholding and BWC handled. Different pay rates for different roles and certifications processed accurately. Books that show you the real financial picture, including the gap between providing care and collecting payment for it.
Revenue Recognition
Revenue Recognition
Billed amounts adjusted to expected reimbursement. Revenue recorded at what you’ll actually collect, not the inflated number on the claim. Your financials reflect economic reality.
Receivables by Payer
Receivables by Payer
Insurance claims tracked and aged by payer. You see which companies are current, which are slow, and which claims need follow-up before they age past filing deadlines.
Common Problems
Recording billed amounts as revenue creates a practice that looks profitable on paper while the bank account stays tight. You billed $60,000 in March. Insurance pays $38,000 in May after adjustments. If the books showed $60,000 in revenue in March, the numbers were never real. You made decisions based on income that was never going to arrive.
The other problem is receivables that pile up without follow-up. Insurance claims that needed additional documentation sit unpursued. Patient balances from two years ago still show as assets. The balance sheet says you’re owed $80,000. Half of that is probably uncollectible, but nobody’s cleaning it up.
Inflated Revenue
Inflated Revenue
Full billed amounts recorded as income. Adjustments come months later as surprise write-downs. The practice looks profitable until the corrections hit. Real performance invisible under the noise.
Stale Receivables
Stale Receivables
Claims and patient balances sitting for months without follow-up. Money left on the table because aging accounts aren’t being worked. Balance sheet assets that will never convert to cash.
What Changes
You see the practice clearly. Revenue at expected collection amounts, not billed amounts. Adjustments recorded when claims are filed, not months later when payment arrives. Receivables that reflect money you’ll actually collect, with uncollectibles written off on a schedule instead of sitting forever.
Cash flow becomes predictable. You know which payers are slow and can plan around the timing. Payroll runs smoothly for staff at varying rates and certifications. The books tell you what the practice actually makes, not what it would make if everyone paid in full and on time.
Real Numbers
Real Numbers
Net revenue after adjustments. Receivables that reflect collectible amounts. A P&L that shows actual practice profitability. Financial statements you can make decisions from.
Cash Flow Visibility
Cash Flow Visibility
Know when money will arrive based on payer timing patterns. Plan for the gap between services and collection. Stop being surprised when payroll is due and insurance hasn’t paid yet.
Northwest Ohio’s Trusted Bookkeeping Partner
The Next Step:
A 15-Minute Discovery Call
Let's talk about your current bookkeeping situation. We'll assess your needs, outline a plan of action, and give you a clear quote.
