Home Health Agencies
Medicare and insurance revenue arrives on payer timelines, not at time of service. Hunter Green CPA tracks your remittances, keeps payroll clean, and maintains books that hold up when regulators or lenders take a look.
The Industry
Skilled home health is not the same business as non-medical home care. Medicare-certified agencies bill insurance and government payers, wait weeks or months for reimbursement, and pay clinicians on a per-visit basis. The revenue side runs on payer schedules, not on what you collected today. This changes everything about how the books need to work.
Most agency owners came up through the clinical side. You know how to deliver care. The financial side of running a Medicare-certified agency is a different challenge. You have payer remittances to reconcile, per-visit payroll to track by clinician, and a payer mix that determines your margins. Your books need to reflect all of it accurately, because regulators, lenders, and potential buyers will expect clean records when they look.
Who This Covers
Who This Covers
Medicare-certified skilled home health agencies providing nursing, physical therapy, occupational therapy, speech therapy, and other clinical services in the home. This page is about the financial and accounting side of running that agency, not about billing, coding, or clinical operations.
What Makes It Different
What Makes It Different
Revenue does not arrive at time of service. It arrives on payer timelines after claims are processed. Clinicians are often paid per visit rather than hourly or salaried. The combination of lagged revenue and visit-based costs makes standard small business bookkeeping a poor fit.
What We Handle
Hunter Green CPA handles the accounting and tax side of your home health agency. We keep the books clean, track your revenue against payer remittances, and organize payroll costs by clinician and visit type. We also give you visibility into your payer mix so you can see where your revenue actually comes from and what your margins look like by payer. This is a specialty focus for the firm, and we understand the financial structure of skilled home health.
We do not do clinical billing or coding. Your billing team or billing company handles claims. What we handle is the accounting once those payments arrive. We reconcile what you were paid against what you expected, record it properly in the books, and keep your financials in shape for whatever comes next. Whether that means a regulatory review, a bank asking for financials, or your own need to understand how the agency is actually performing.
Revenue Tracking and Payer Mix
Revenue Tracking and Payer Mix
We track your collected revenue against your payer remittances and keep it organized by payer type. You will know what percentage of your revenue comes from Medicare, Medicaid, private insurance, and private pay. That visibility matters for planning, for understanding your margins, and for any external review.
Payroll and Cost Tracking
Payroll and Cost Tracking
Per-visit pay for field clinicians needs accurate tracking. We keep your payroll costs organized by clinician type and visit type so you can see your true cost to deliver care. When your books close each month, the payroll records are clean and the numbers add up.
Common Problems
The lag between delivering care and collecting payment creates confusion. Visits happen in March, but the money shows up in May. If you are only looking at the bank account, you cannot tell how the agency is actually performing. Billed revenue and collected revenue are two different numbers, and many owners do not have a clear view of either one. Without proper tracking, you are guessing at cash flow instead of managing it.
The other common problem is books that are not ready for scrutiny. State surveyors may ask about your financials. A bank will want organized records before extending a line of credit. If you ever want to sell the agency or bring in a partner, the first thing they will request is clean financial statements. Too many agencies let the books slide until there is an urgent need, and then the catch-up work is expensive and stressful.
Receivables vs Reality
Receivables vs Reality
You billed a hundred visits last month. How much of that has actually been collected? What is sitting in accounts receivable, and for how long? Without monthly reconciliation, the gap between billed and collected widens without anyone noticing until cash gets tight.
Scrambling for Records
Scrambling for Records
A lender asks for two years of financials. A regulator wants documentation. A potential acquirer requests due diligence materials. If the books are messy or behind, you are now paying someone to reconstruct history under deadline pressure. That is a bad position to be in.
What Changes
You get a clear view of where the agency actually stands. Each month, the books close with revenue tracked against remittances, payroll costs organized by clinician and visit, and your payer mix visible. You know what you collected, what it cost to deliver that care, and what the margin looks like. You stop guessing and start planning from actual numbers.
When someone needs to see your financials, they are ready. A regulator, a lender, an investor, or a buyer can look at your books and see an organized, accurate picture of the business. The Full-Service Bookkeeping and Bookkeeping and Tax Package keep this current month after month. If you are behind, Catch-Up Bookkeeping gets you current first. And when it is time to think about entity structure, retirement contributions, or reducing your tax burden, Tax Strategy is part of the conversation.
Monthly Clarity
Monthly Clarity
Books closed every month. Revenue reconciled. Payroll costs tracked. Payer mix visible. You can look at your financials and actually understand how the agency performed, not just hope the bank account balance tells the story.
Ready When It Matters
Ready When It Matters
If you want to open a line of credit, bring on a partner, or sell the agency, the financials are already in order. If a surveyor asks questions, the records are organized. You are never scrambling because the books have been kept right all along.
Your Trusted CPA
Next Step:
A Short Conversation
Tell us about your business and what you need help with. We'll ask a few questions, explain how we can help, and tell you exactly what it will cost.