Accounting for home care agencies, practices and clinics
Payroll is your biggest number and your payers set the pace of your cash. We keep the books that tell you what you actually earned, what you’re still owed, and which location or program is carrying the rest.
When payroll is most of the business
In home care and clinical work, labor isn’t one line on the P&L — it practically is the P&L. Caregivers and clinicians work split shifts across homes, sites and programs. Overtime, differentials, mileage, per-diems and last-minute coverage all land in the same pay run, and by the time it hits the ledger as a single lump sum, the useful information is gone.
We record payroll so it stays readable: wages, taxes and burden mapped to the location, program or service line that generated them, and accrued into the right period rather than whenever the withdrawal cleared. That one habit is usually the difference between a gross margin you believe and a number you argue with.
Insurance receivables and the gap between billed and banked
You bill in one month, get paid in another, and the payment rarely matches the invoice. Partial payments, adjustments, denials, takebacks and remittances covering dozens of claims at once — none of it lines up on its own. We reconcile what actually hits the bank against what was billed, carry the receivable honestly, and keep adjustments and write-offs visible instead of buried.
The result is a balance sheet that shows real exposure. You can see how much is outstanding, how old it is, and where cash is genuinely coming from — which matters far more than a revenue figure that assumes everyone pays in full.
To be clear about scope: this is accounting, not medical billing. We don’t code claims or manage your clearinghouse. We take what your billing team or software produces and make sure the books reflect it correctly, month after month.
We work well alongside your internal team
Plenty of agencies and practices already have someone in-house — an office manager, a controller, a full accounting department. We’re comfortable either way: taking the books entirely off your hands, or slotting in around the people you already have and handling the parts they don’t have time for.
One of our healthcare clients put it best after we worked directly with their internal accounting staff.
“Duban Accounting was nothing but professional. They performed expediently and seamlessly with our internal accounting team. Such a pleasure working with Moshe!”
A bookkeeper on the books, a controller over them
Every bookkeeper at Duban Accounting passes the Duban Skills Test before touching a client file — and only 15% of candidates pass, even though each one already holds a QuickBooks ProAdvisor certification and an accounting degree. Then a controller reviews every close, which is exactly what you want when payroll accruals and payer receivables are involved.
Clean books pay off everywhere else too: tax planning that isn’t a scramble, records that hold up for licensing renewals, audits and lender requests, and fractional CFO support when you’re opening a location, adding a program or planning around a payer change.
Profitability by location, program and service line
Two locations can post similar revenue and land in completely different places once staffing costs, coverage patterns and payer mix are accounted for. We set up the chart of accounts and tracking so each site or program reports on its own, alongside a company-wide view — so growth decisions come from evidence rather than instinct.
The parts of healthcare accounting that get messy fast.
Wages, taxes and burden allocated across shifts, sites and programs, and accrued into the period they belong to.
What you billed versus what arrived, aged and visible — with adjustments, denials and write-offs recorded, not hidden.
Lump remittances from payers, plus patient and private-pay deposits, matched back to the revenue that produced them.
Each office, branch or program reporting on its own, alongside a roll-up you can read in one sitting.
Per-diem clinicians, agency staff and vendors tracked all year with W-9s collected, so January is routine.
Financials organized and reviewed before they go out, so a renewal, an audit request or a loan file doesn’t stall you.
From payroll guesswork to numbers you can staff by.
Talk with us
A consultation about your locations, your payers, your payroll setup and what your books can’t currently tell you.
Meet your team
You’re matched with a skills-tested bookkeeper used to payroll-heavy, multi-site books — plus the controller reviewing them.
We get you current
Payroll re-mapped, payer deposits reconciled, receivables aged properly and prior periods brought fully up to date.
Close, every month
Accounts reconciled, location and program reporting delivered, and a controller’s review behind every number.
Healthcare accounting, answered.
Do you work with home care agencies specifically?
Yes — home care is real client work for us, not a category we added to a list. Multi-caregiver payroll, shift-based labor costs and payer receivables are the exact conditions we’re set up for, and we’ve done this work for Oasis Homecare.
Can you work alongside our internal accounting team?
Absolutely, and we do it often. We can take the books entirely, or work as an extension of the staff you already have — handling reconciliations, payroll allocations and the monthly close while your team keeps what it does best. Elie, the controller at Oasis Homecare, described exactly that arrangement.
How do you handle insurance receivables in the books?
Billed amounts are carried as receivables and reconciled against what actually lands in the bank, with contractual adjustments, denials and write-offs recorded as separate, visible entries. You get an aging you can trust rather than a revenue number that assumes full payment. Note that we handle the accounting side — we don’t code or submit claims.
Can we see results by location or by program?
Yes. We build the chart of accounts and tracking so revenue, payroll and overhead land on the right site or program from the start. You get a P&L per location and a company-wide roll-up from the same set of books.
What does it cost?
A flat monthly fee, quoted after a free consultation. Pricing depends on transaction volume, headcount, how many locations you run and the shape your books are in today — so we look first, then quote. No surprise hourly bills.
Ready to know what each location really earns?
Book a free consultation and we’ll determine the best way to help your business reach its full potential. If we’re not the right fit, we’ll point you to a resource that is.