Senior Care & Home Health
Bookkeeping for agencies sending caregivers into homes. Insurance billing, Medicaid reimbursements, and payroll for staff with variable hours.
The Industry
Home health is a labor business with a billing problem. You send caregivers into homes. They provide services. Then you wait to get paid. Medicaid reimburses on its own schedule. Insurance processes claims when it gets around to it. Private pay clients sometimes forget. The work happens today. The money arrives weeks or months later.
Meanwhile, payroll is due every week or two. Caregivers need to be paid whether the reimbursements have arrived or not. The gap between providing care and collecting payment is where home health agencies get squeezed. Managing that gap is half the business.
Who This Covers
Who This Covers
Non-medical home care, home health aides, personal care services, companion care, senior care agencies, disability services, PASSPORT waiver providers. Any agency sending caregivers to client homes.
What Makes It Different
What Makes It Different
Multiple payer sources with different billing requirements. Medicaid waiver programs with specific documentation. High caregiver turnover and variable schedules. Mileage reimbursement for staff traveling between clients. Ohio-specific compliance for home care licensing.
What We Handle
Monthly bookkeeping with revenue tracked by payer source. Medicaid, insurance, and private pay separated so you can see what’s been billed, what’s been collected, and what’s sitting unpaid. When a claim gets denied or a payment runs late, it shows up in the reports instead of getting lost in the shuffle.
Payroll for caregivers with variable hours, multiple clients, and different pay rates. Mileage tracked and reimbursed correctly. Ohio BWC handled for workers going into client homes. Books that show you the real margin on each payer type, not just total revenue minus total expenses.
Payer Tracking
Payer Tracking
Revenue separated by Medicaid, insurance, and private pay. Billed versus collected tracked for each. You see which payers are current and which are running behind.
Caregiver Payroll
Caregiver Payroll
Variable hours across multiple clients. Different rates for different service types. Mileage reimbursement. Overtime calculated correctly. Processed on time every pay period.
Common Problems
Home care agencies often don’t know their real margin by payer. Medicaid pays one rate. Insurance pays another. Private pay clients pay a third. Each has different billing requirements and collection timelines. Without separating them, you can’t tell which business is worth pursuing and which is barely covering costs.
Turnover makes payroll complicated. Caregivers come and go. Schedules change weekly. Someone picks up extra shifts, someone else calls out. By the time you calculate hours, overtime, and mileage, half a day is gone. And if you get it wrong, you’re either overpaying or dealing with frustrated staff.
Reimbursement Lag
Reimbursement Lag
Services provided in March. Billed in April. Paid in June. Maybe. Denied claims sit unworked because nobody’s tracking them. Revenue that was earned never actually arrives.
Payroll Complexity
Payroll Complexity
Dozens of caregivers with different hours every week. Multiple clients, multiple rates, mileage to calculate. Getting it right takes hours. Getting it wrong costs trust and money.
What Changes
You see the business by payer type. Which reimbursement sources are profitable after accounting for billing time and collection delays. Which ones pay reliably and which ones require constant follow-up. You can make decisions about which clients to take on based on how the numbers actually work out.
Payroll runs without eating your week. Hours calculated, overtime caught, mileage tracked, deposits made. Caregivers get paid correctly and on time. You spend your time on care coordination and client relationships instead of spreadsheets.
Collection Visibility
Collection Visibility
Billed versus collected tracked by payer. Aging receivables flagged before they go stale. Denied claims caught and addressed instead of written off.
Margin by Payer
Margin by Payer
See what you actually net from Medicaid versus private pay versus insurance after factoring in billing effort and payment timing. Focus on the business that’s worth the work.
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.
