Healthcare Accounting Support
Outsourced Accounting Services for Healthcare
We provide specialized outsourced accounting services for healthcare businesses, helping providers manage bookkeeping, reporting, and day-to-day financial operations.
- Healthcare Experience
- Flexible Engagements
- U.S. Business Focus
Healthcare Expertise
Specialized healthcare accounting.
Flexible Support
Support that fits your needs.
Existing Workflows
Fits your existing systems.
Secure Data Handling
Protecting your financial data.
Accounting Experts for Healthcare Businesses
Healthcare businesses have unique accounting needs, from managing daily transactions and expenses to keeping financial records organized and current. Xconcile provides outsourced accounting solutions for healthcare businesses in the U.S., helping healthcare businesses and CPA firms manage bookkeeping, reconciliations, financial reporting, and ongoing accounting work within their existing workflows.
Whether you operate a medical practice, dental practice, clinic, or other healthcare organization, our team provides consistent accounting support to help keep your financial operations organized.
- Dedicated Resources
- US Accounting Experience
- Flexible Support
Key Challenges
Common Accounting Challenges in Healthcare
Healthcare businesses often manage complex financial activity while their teams focus on patients, employees, and day-to-day operations.
Expertise
Healthcare Accounting Services
We provide flexible accounting support for healthcare businesses based on the scope and complexity of your operations.
Bookkeeping Services
Maintain organized financial records and record transactions accurately.
Bank & Credit Card Reconciliation
Reconcile accounts and review financial records regularly.
Accounts Payable Support
Help organize bills, vendor transactions, and payment records.
Accounts Receivable Support
Maintain organized receivable records and help track outstanding balances.
Month-End Close Support
Support a consistent month-end accounting process so your financial records stay current.
Financial Reporting
Receive organized financial reports that give you a clearer view of business performance.
General Ledger Management
Maintain accurate account classifications and organized general ledger records.
Accounting Cleanup
Bring disorganized or outdated books up to date and establish a more consistent accounting process.
Sub-Industries
Types of Healthcare Businesses We Support
From everyday bookkeeping to strategic financial planning, our outsourced accounting services help businesses maintain accurate financial records.
Bookkeeping
- Monthly bank and credit card reconciliations
- Recording insurance payments (ERA/EOB) and patient co-pays
- Managing vendor payables for lab services and medical supplies
- Tracking multiple revenue streams (insurance, patient payments, procedures)
Accounting
- Monthly Profit & Loss statements by location or department
- Revenue Cycle Management (RCM) oversight tracking denied claims and aging A/R
- Cash flow forecasting to manage insurance payment lag
- Accrual accounting for services rendered but not yet billed
Payroll
- Managing base salaries for clinicians and support staff
- Processing Physician Compensation based on RVUs (Relative Value Units) or net collections
- Handling multi-state payroll for group practices with multiple locations
- Managing complex benefit structures (health insurance, malpractice, CME allowances)
Tax Preparation
- Form 1040 / 1120-S preparation for physician-owned practices
- Section 179 deductions for medical imaging or surgical equipment
- Tracking CME (Continuing Medical Education) and professional dues
- Managing S-Corp distributions and reasonable compensation
Software Stack
- QuickBooks Online / Sage Intacct (Accounting)
- AdvancedMD / Athenahealth / Kareo (Practice Management/Billing)
- Gusto / ADP (Payroll)
- Bill.com (AP Automation)
Bookkeeping
- Tracking high-volume dental lab invoices
- Reconciling daily patient payments (insurance + patient portions)
- Managing merchant fees from various financing options (CareCredit, LendingClub)
- Recording treatment plan deposits and scheduling payments
Accounting
- Treatment plan profitability analysis (Crowns vs. Fillings vs. Implants)
- Tracking Case Fee liabilities for long-term orthodontic contracts
- Managing deferred revenue for pre-paid treatment plans
- Production vs. collection analysis
Payroll
- Incentive-based pay for hygienists (production bonuses)
- Handling multi-state payroll for group practices
- Processing commission structures for treatment coordinators
Tax Preparation
- Specialized depreciation for dental chairs and X-ray units
- State-specific dental tax compliance
- Managing equipment leases vs. purchases (Section 179 vs. bonus depreciation)
Software Stack
- Dentrix / Open Dental / Eaglesoft (Practice Management)
- QuickBooks Online (Accounting)
- Paychex / Gusto (Payroll)
Bookkeeping
- Managing session-based billing and scheduling integration
- Recording out-of-network (OON) reimbursements from insurance
- Tracking telehealth software subscriptions (Zoom, Doxy.me)
- Managing sliding-scale fee structures
Accounting
- Monitoring "No-show" costs and utilization rates
- Tracking therapist productivity and session capacity
- Managing grant-funded programs for non-profit mental health centers
Payroll
- Flexible pay cycles for per-session contractors (1099) and salaried clinicians (W-2)
- Managing supervision stipends for licensed supervisors
- Handling CEU (Continuing Education Unit) reimbursements
Tax Preparation
- Home office deductions for telehealth providers
- Managing self-employment tax for solo practitioners
- Tracking professional liability insurance deductions
Software Stack
- SimplePractice / TherapyNotes / TheraNest (Practice Management)
- FreshBooks / Xero (Accounting)
- Gusto (Payroll)
Bookkeeping
- Reconciling high-frequency patient visits
- Tracking durable medical equipment (DME) sales (braces, pillows, supplements)
- Managing insurance authorization tracking
- Recording copays and deductibles
Accounting
- Calculating Revenue Per Visit benchmarks
- Tracking authorized visits remaining per patient
- Managing inventory for retail DME products
- Workers' comp billing reconciliation
Payroll
- Performance bonuses based on patient retention and volume
- Managing multi-location therapist scheduling
- Processing per-diem rates for contract therapists
Tax Preparation
- Depreciation of therapeutic equipment (ultrasound, laser therapy)
- Tracking massage therapy vs. clinical adjustments for sales tax purposes
- Managing retail sales tax on DME products
Software Stack
- WebPT / Jane App / Clinicient (Practice Management)
- Xero / QuickBooks Online (Accounting)
- Staffology / Gusto (Payroll)
Bookkeeping
- Complex retail inventory reconciliation (skincare products)
- Recording gift card sales vs. redemptions
- Managing consignment inventory for injectables (Botox, fillers)
- Tracking membership programs and package sales
Accounting
- Sales Tax Nexus tracking for cosmetic services vs. medical services
- Tracking high-margin cosmetic injection costs (COGS analysis)
- Managing revenue recognition for package deals and memberships
- Inventory valuation for skincare retail
Payroll
- Commission calculations for estheticians and injectors
- Tracking tips for service staff
- Managing medical vs. spa staff payroll allocation
Tax Preparation
- Managing "Dual-Entity" structures (Medical PC vs. Retail/Wellness LLC)
- Retail sales tax filings for product sales
- Nexus considerations for multi-state operations
- Equipment depreciation for laser systems
Software Stack
- Zenoti / Boulevard / Vagaro (Spa Management)
- QuickBooks Online (Accounting)
- Gusto / ADP (Payroll)
- Avalara (Sales Tax)
Bookkeeping
- High-volume vendor management for reagents and diagnostic kits
- Reconciling global vs. technical billing components
- Managing multiple payer contracts and fee schedules
Accounting
- Capital expenditure (CapEx) tracking for MRI/CT machines
- Inter-departmental cost allocation (radiology, lab, cardiology)
- Managing equipment leases and service contracts
Payroll
- Managing 24/7 staffing shifts and on-call stipends
- Tracking radiologist and pathologist reading fees
- Processing shift differentials for overnight staff
Tax Preparation
- Multi-state nexus if diagnostic results cross state lines
- Complex tax structures for imaging partnerships
- Section 179 and bonus depreciation for medical equipment
Software Stack
- Medikamart / Epic / Cerner (Practice Management/LIMS)
- Sage Intacct / NetSuite (Accounting)
- ADP Comprehensive (Payroll)
Bookkeeping
- Managing travel and mileage reimbursements for field staff
- Reconciling Medicaid/Medicare daily billing cycles
- Tracking EVV (Electronic Visit Verification) integration
Accounting
- Cost-per-visit analysis by service type
- Managing grant-funded programs and restricted funds
- Tracking nurse and aide utilization rates
Payroll
- GPS-verified timekeeping integration for field staff
- Complex overtime for 24-hour live-in caregivers
- Managing weekend and holiday premium pay
Tax Preparation
- Tracking FICA exemptions for certain family caregivers
- Managing state-specific caregiver tax credits
- Handling 1099 vs. W-2 classification for caregivers
Software Stack
- AlayaCare / Homecare Homebase / ClearCare (Home Health Management)
- QuickBooks Online (Accounting)
- Paycor / ADP (Payroll)
Bookkeeping
- Batch and expiry-date inventory tracking
- Reconciling PBM (Pharmacy Benefit Manager) clawbacks and reimbursements
- Managing DIR fees and pharmacy network reconciliations
Accounting
- Cost of Goods Sold (COGS) optimization with FIFO/LIFO
- Tracking high-value inventory turnover rates
- Managing 340B drug pricing program compliance
Payroll
- Managing pharmacist licensing stipends
- Hourly technician shift management
- Handling on-call pharmacist compensation
Tax Preparation
- Section 471 inventory valuation methods
- 340B drug pricing program compliance and reporting
- Managing controlled substance inventory for DEA compliance
Software Stack
- PioneerRx / Liberty / QS/1 (Pharmacy Operations)
- NetSuite / TallyPrime (Accounting/Inventory)
- ADP / Paychex (Payroll)
Why Choose Us
Why Healthcare Businesses Choose Xconcile for Accounting Support
Build a stronger accounting function with experienced professionals who understand U.S. business requirements, accounting workflows, and day-to-day financial operations.
Experienced Professionals
Skilled professionals for bookkeeping and financial reporting.
U.S. Accounting Expertise
Support aligned with U.S. accounting practices and workflows.
Financial Records
Keep financial records accurate, organized, and up to date.
Flexible Support
Choose support that fits your accounting needs and workload.
Scalable Capacity
Add accounting capacity as your business needs continue to grow.
- Accounting Experience
- 10+
- Businesses Supported
- 1K+
- Accounting Professionals
- 50+
- Reconciliation Accuracy
- 98%
FAQ
Frequently asked questions
Find answers to common healthcare accounting questions.
Healthcare accounting covers the bookkeeping, reconciliations, month-end close, and financial reporting that medical, dental, therapy, and other healthcare businesses need to keep their financial records organized and current.
We support medical and specialized practices, dental and orthodontic clinics, mental health and behavioral therapy providers, physical therapy and chiropractic centers, dermatology and medical spas, outpatient and diagnostic centers, home healthcare services, and pharmacies and medical suppliers.
Yes. Our team records transactions, reconciles bank and credit card accounts, supports accounts payable and receivable, and maintains your general ledger, all within your existing systems and workflows.
Outsourcing gives you consistent accounting support without building a full in-house accounting department. It keeps recurring tasks off your team's plate, helps avoid month-end pressure, and scales as your healthcare business grows.
Yes. An NDA is signed before any data access, only assigned team members can access your files, data is transferred with controlled access, and your financial data is never sold or shared with outside parties.
Yes. We bring disorganized or outdated books up to date and help establish a more consistent accounting process going forward.
Schedule a call with our team. We'll review your accounting needs, systems, and workload, then recommend the support that fits your healthcare business.