Healthcare Bookkeeping Services That Reconcile Every Payer

Your practice management system records charges at your full fee schedule. Your bank records a net deposit several weeks later. Between them sit allowed amounts, adjustments, denials, patient responsibility, and recoupments, and most practices never reconcile them. Revenue then looks larger than it really is.

We reconcile deposit by deposit, matching each ERA to its claims and posting adjustments separately. Your income statement shows revenue you expect to keep.

A denial nobody records is a denial nobody works. We track denied and underpaid claims as separate categories, so your billing team knows what to appeal and you know what unappealed claims cost.

Contractual adjustments stay separate from bad debt write-offs, since the first is the price of being in a network and the second is a collections problem. Over a few cycles this gives you net collection rate by payer, which shows whether a contract is worth renewing. Co-pays, deductibles, coinsurance, and payment plans are tracked as patient responsibility, so front desk collection is measured.

Aging by payer shows exactly who is late and whether that is normal. We flag claims nearing timely filing limits, where a slow claim becomes a permanent loss.

A practice can be profitable on paper and still come up short in a payroll week, because money arrives on the payer's schedule rather than yours. We build a cash view around your payer mix and historical days in AR to show what is realistically landing over the next several weeks, apart from self-pay balances and patient payment plans. Fixed obligations such as rent, equipment leases, and provider draws are set against it.

Healthcare payroll carries variables generic support ignores, such as on-call shifts, per diem coverage, split clinical and administrative roles, and locum arrangements, all of which need correct coding before labor cost means anything. Supplies, lab costs, and equipment depreciation belong in categories that match how you buy them.

Credentialing and licensing costs are tracked by provider, so the cost of each clinician stays visible to you.

Once revenue is coded by rendering provider and service line, useful questions become answerable. Which panel generates collections rather than charges. Is an ancillary service covering its staff. We report collections and margin by provider, service line, and location, and can map production against wRVU if you track them. Groups use it for compensation.

Owner pay in a practice is rarely one salary line. Draws, guaranteed payments, distributions, and year-end true-ups each need separate tracking if the tax return is going to make sense. We keep them clean through the year and maintain the equity detail your CPA needs at K-1 time, ready for 1065, 1120S, 1120, or Schedule C.

Practice management systems are built to submit claims and post payments. Accounting systems are built to produce financial statements. Nothing joins them by default, and the manual bridge between the two is where most books go wrong. That bridge is the service.

Coding always stays with your team. CPT and ICD-10 selection is a clinical decision, and we work from the superbill, charge entry, and payment posting your billing operation produces rather than second-guessing it. If your system exports payment, adjustment, or AR detail, we reconcile it to your ledger every single month.

Primary care and family medicine, specialty clinics, dental groups, behavioral health and therapy practices, physical therapy and chiropractic clinics, veterinary hospitals, med spas, home health agencies, imaging centers, and multi-site provider groups. Payer mix differs in each.

We report by location and consolidated in the same close, so sites can be compared on collections, payer mix, and labor cost. Groups running separate practice, management, and real estate entities are handled the same way, with each entity kept on its own separate books and consolidated reporting across all of them, so every return stays clean at tax time.