Bookkeeping, payroll, and reporting for medical groups and senior health operators who need to know what a month really earned before the deposits catch up.
A medical practice does not get paid when it does the work. It gets paid weeks later, at a rate somebody else decided, after a clearinghouse takes a look. That gap between service and deposit is where most practice books get fuzzy, and it is the first thing we straighten out.
Baum's Accounting Services brings 18 years in finance roles, including CFO experience at a mortgage bank, and has run the numbers for healthcare and senior-health operators. Our experience includes physician practices, home healthcare providers, and senior care organizations. We work with practices in Lexington and across central Kentucky, on site or virtually, depending on what your office needs. The goal is simple: a close that lands every month, reporting you can read without a decoder ring, and enough forward view to make staffing and equipment calls with actual numbers behind them.
Charges are not revenue. Contractual adjustments, denials, patient responsibility that ages out past 120 days, and secondary billing all sit between what you posted and what hits the account. If your books record the deposit and nothing else, you lose the ability to see whether a payer got slower, whether a fee schedule changed, or whether your front desk stopped collecting copays. We reconcile deposits against remittance detail so revenue lands in the right month and the adjustments show up as adjustments. From there, monthly reporting shows collections by payer and how long each one is taking, which is the number that actually predicts next quarter's cash.
Practice payroll is rarely one flat schedule. You have salaried providers, hourly clinical staff, front office, sometimes a per diem or a moonlighting arrangement, and often a production or incentive component layered on top. Add benefits, retirement deferrals, and multi-state withholding when someone lives across the river, and a small mistake compounds fast. We run payroll through ADP, Paychex, Paycor, Gusto, RUN Powered by ADP, or QuickBooks Payroll, keep the payroll tax filings on schedule, and make sure provider compensation ties back to whatever your comp formula actually says.
Most practice owners get a balance sheet and an income statement and no context. We build reporting around the decisions you actually make: whether to add a provider, whether to keep a location open, whether that new piece of equipment pays for itself. That means revenue and cost per provider, staffing cost as a share of collections, and a rolling cash forecast that accounts for the lag in your receivables. Budget versus actual runs every month, so a variance surfaces within weeks instead of at year end. If you want a KPI dashboard, we build one with the four or five numbers that matter, not thirty.
Baum's Accounting Services is not a CPA firm and does not prepare income tax returns. When your return needs to be filed, we work with an outside CPA and hand over clean, closed books so they can start from records that already tie out. We also do not give clinical advice or advise on billing codes, and we do not claim any HIPAA certification. The work here is bookkeeping, payroll, reporting, and controller or CFO-level advisory around the practice's numbers. Sales tax compliance and quarterly estimated payments are in scope. Your coders and your CPA stay in their lanes, and so do we.
We work with them. Your billing company or in-house biller owns coding, claim submission, and follow-up. We take their remittance and deposit data and turn it into accurate books and reporting. If the numbers coming out of billing do not reconcile to the bank, that is exactly the kind of gap this work surfaces.
That is fractional controller and CFO territory, and yes. We model the new provider's expected collections against salary, benefits, added staffing, and the ramp period before their panel fills. You get a month-by-month cash picture instead of a gut call. Most owners find the ramp assumption is where the real risk sits.
As far back as needed. Cleanup work starts with reconciling bank and merchant accounts, then rebuilding revenue so deposits tie to remittances. Once history is accurate, monthly close keeps it that way. Bring what you have at the consultation, even if it is messy, and We will tell you the real scope.
Other work in this area that tends to come up in the same conversation.
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Read moreBook a consultation and we will walk through the work, the timing, and who does what.
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