Medical & Healthcare
Healthcare practices deal with insurance reimbursements, expensive equipment, and compliance costs. We handle the books so you can focus on patients.
The Industry
Healthcare billing works differently than most businesses. You provide the service today, submit the claim, and wait 30 to 60 days to find out what insurance will actually pay. Then you chase the patient for their copay or deductible. A $200 procedure might result in an insurance payment of $140, a patient portion of $35, and $25 written off as a contractual adjustment. Multiply that across hundreds of patient visits per month and tracking it all becomes its own full-time job.
Most practice owners are still treating patients every day. The dentist is doing root canals. The chiropractor is adjusting backs. The therapist has a full caseload. Running the business happens in the cracks between appointments, which means bookkeeping gets pushed to late nights or ignored entirely. Add in malpractice insurance renewals, equipment purchases, licensing fees, and payroll for your team, and it becomes clear why financial management falls behind.
Who This Covers
Who This Covers
Dental offices, chiropractic clinics, optometrists, mental health practices, veterinarians, physical therapy practices, and home health care agencies. Any healthcare practice in Nampa, Boise, or the Treasure Valley that bills insurance and manages a clinical team.
What Complicates It
What Complicates It
Insurance reimbursement delays that create cash flow gaps. Multiple payer sources with different contracted rates. Expensive diagnostic and treatment equipment needing proper depreciation. Malpractice insurance, licensing renewals, and continuing education requirements. Payroll for licensed providers, hygienists, assistants, and front desk staff.
What We Handle
Revenue in healthcare is not straightforward. Insurance payments need reconciliation against what was billed to catch underpayments and denials. Patient portions need tracking so receivables don’t age into balances you’ll never collect. We set up systems that show what’s been billed, what’s been paid, and what’s still outstanding. You can see actual collected revenue by payer type instead of just looking at the total in your bank account.
Healthcare practices have tax deductions that general bookkeepers miss. Dental chairs, digital x-ray systems, and therapy equipment can qualify for Section 179 depreciation. Malpractice insurance is a significant annual expense. Continuing education, licensing renewals, and professional association dues add up throughout the year. We make sure your tax return captures all of it. As Enrolled Agents, we can also represent you directly before the IRS if any notices arrive or if questions come up during an audit.
Revenue Tracking and Reconciliation
Revenue Tracking and Reconciliation
Insurance payment reconciliation to catch underpayments before it’s too late to appeal. Patient receivables tracked with aging reports showing what’s 30, 60, and 90 days outstanding. Revenue categorized by payer type so you know which insurance contracts are actually worth keeping. A clear picture of collected revenue versus billed revenue.
Tax Strategy and Enrolled Agent Support
Tax Strategy and Enrolled Agent Support
Equipment depreciation using Section 179 where it makes sense for your cash flow. All deductible expenses captured throughout the year. Malpractice insurance, licensing fees, CE credits, professional dues. Quarterly estimates based on your practice’s actual income pattern. If the IRS sends a letter, we respond on your behalf.
Common Problems
Insurance claims get billed and practices assume the payment will show up eventually. But insurance companies underpay claims, apply the wrong fee schedule, or deny reimbursement entirely. Without proper reconciliation, nobody notices when a $120 claim gets paid at $85. Across hundreds of claims per month, underpayments quietly add up to thousands of dollars in lost revenue every year. Patient balances sit in the system past 90 days until they’re essentially uncollectible.
Tax season arrives and nobody is ready. The dentist knows a new chair was purchased last spring but can’t find the invoice or remember the exact amount. Malpractice insurance was paid in December but it might have been a prepayment for the following year. Continuing education costs are mixed in with what looks like personal travel. Quarterly estimates were never set up because the practice was too busy, and now there’s a $12,000 tax bill due in April with no cash set aside to pay it.
Revenue That Never Gets Collected
Revenue That Never Gets Collected
Insurance payments accepted without verification against what was billed. Underpayments and denials go unnoticed because no one reconciles the explanations of benefits. Patient balances sit without follow-up until they’re past the point of collection. The practice bills $80,000 per month but only collects $58,000 and nobody can explain the gap.
Tax Bills That Catch You Off Guard
Tax Bills That Catch You Off Guard
Equipment purchases not tracked properly for depreciation. Deductible expenses mixed with personal spending on the same credit card. No quarterly estimates set up so April becomes a crisis. The practice had a profitable year but the tax bill is a surprise because nobody planned for it.
What Changes
Insurance payments get reconciled against claims on a regular schedule. Underpayments are identified while there’s still time to appeal. Patient receivables are tracked with systematic follow-up before balances become write-offs. You can see the actual collected revenue by service type and payer, which helps you decide which insurance panels are worth staying on and which are costing you money.
Tax preparation is handled by people who understand healthcare practices. Equipment depreciation gets maximized using Section 179 where it benefits your situation. Every deductible expense is captured and properly categorized throughout the year. Quarterly estimates keep you from scrambling in April. And because we’re Enrolled Agents, we don’t just prepare your return and send you on your way. If the IRS has questions, we handle the response directly.
Revenue You Actually Collect
Revenue You Actually Collect
Insurance reconciliation that catches underpayments and denials while they can still be corrected. Patient receivables tracked with aging reports and follow-up procedures. Visibility into which payers and services generate the most collected revenue. Financial decisions based on real collection data instead of assumptions about what you billed.
Tax Preparation That Fits Your Practice
Tax Preparation That Fits Your Practice
Equipment depreciated correctly from day one. Every deductible expense tracked and captured. Quarterly estimates that match your income pattern so April is predictable. Enrolled Agent representation if the IRS sends a notice or requests additional documentation. You focus on treating patients while we keep the financial side running clean.
The Treasure Valley's Tax and Accounting Team
The Next Step:
A Short Conversation
Tell us what you're dealing with. We'll listen, answer your questions, and give you a straightforward quote.
