Questions
Answers to the tax and accounting questions that come up when you're running a business.
My practice management software shows one revenue number and my bank shows another. Which is right?
Both numbers are telling you something real, but neither gives the complete picture. Your software tracks what you charged and what's owed after adjustments. Your bank shows what actually collected. Proper bookkeeping reconciles both.
Read answerCash basis or accrual: which fits a medical business?
Cash basis is simpler and works for many small practices, but insurance reimbursement lag and prepaid packages mean medical businesses often need accrual-style visibility. Many owners start with cash-basis books while tracking receivables and package liabilities separately.
Read answerA client prepaid for a package of sessions. Is that income now?
No. Until the sessions are delivered, that money is a liability, not income. You recognize revenue as each session is completed, not when the payment arrives.
Read answerWhat does a properly built chart of accounts do for a medical business?
A properly built chart of accounts separates revenue by service line, splits direct delivery costs from overhead, and tracks prepaid package liabilities. Without this structure, your books show totals but cannot answer margin questions.
Read answerWhich monthly reports actually matter for my business?
The core set includes the profit and loss statement, balance sheet, and cash movement report. Depending on your business, you may also need receivables aging and margin by service line to see the full picture.
Read answerHow can I tell which of my services earn money and which just stay busy?
Track the direct costs that go into each service and compare them to what you charge. Many owners find that their busiest services aren't their most profitable, and without cost tracking there's no way to know which is which.
Read answerI did my own QuickBooks setup and I am afraid to look at it. What now?
DIY QuickBooks files with miscategorized transactions and unusable reports are extremely common. We assess whether to repair or rebuild, restructure the accounts for your type of medical business, reconcile everything, and hand back books you can actually trust.
Read answerWhy does my profit and loss look fine while my bank account feels empty?
Your profit and loss statement and your bank account measure different things at different times. The gap usually comes from insurance receivables not yet collected, inventory purchased but not used, loan principal payments, prepaid package cash already spent, owner draws, and taxes never set aside.
Read answerDo you take over my bills and invoicing if I want that too?
Yes. Hunter Green CPA offers accounts payable and accounts receivable as add-on services starting at $100 per month each. Bills get tracked and paid on time, invoices go out promptly, and everything is recorded in your books.
Read answerHow long do I need to keep receipts and financial records?
Keep most business financial records for seven years to cover the IRS's standard audit window and extended periods for income understatement. Payroll records need at least four years. Cloud bookkeeping with digital receipt storage makes retention automatic rather than a filing cabinet project.
Read answerMy side business made real money this year. Why is my refund gone?
Your business profit stacks on top of your W-2 clinical income and gets taxed at your highest marginal rate, plus self-employment tax. The W-2 withholding that used to produce refunds was never meant to cover this extra layer.
Read answerWhen does an S corporation election start making sense?
An S corporation election makes sense when the tax savings on distributions exceed the added costs of payroll, a separate tax return, and compliance with reasonable-compensation rules. There's no universal income threshold. It depends on your actual profit and what the overhead will cost you.
Read answerHow do quarterly estimated payments actually work?
The IRS requires self-employed individuals to pay taxes throughout the year via four quarterly payments. Missing these payments triggers penalties even if you pay the full balance in April. Safe harbor rules based on last year's tax make the amounts predictable, and clinicians with W-2 jobs can sometimes increase withholding instead.
Read answerWhat deductions do medical business owners commonly miss?
Medical business owners often miss vehicle and mileage expenses, continuing education costs, professional insurance premiums, and retirement contributions. The common thread is poor documentation throughout the year.
Read answerDoes the QBI deduction still exist, and do I qualify?
Yes, the 20 percent qualified business income deduction is now permanent. But healthcare businesses are classified as specified service trades, which means income thresholds determine whether you can claim it.
Read answerHow much can my business put into retirement for me in 2026?
For 2026, a solo 401(k) allows contributions up to $72,000 if you're under 50, $80,000 if you're 50 or older, and $83,250 for ages 60 to 63. A SEP IRA caps at $72,000 but requires much higher income to reach that level.
Read answerI bought an expensive laser or piece of equipment. How does the write-off work?
You can often deduct most or all of the equipment cost in the first year using Section 179 or bonus depreciation. This applies even if you financed the purchase with a loan.
Read answerWhat changed with 1099 rules, and what do I file this January?
The $2,000 reporting threshold applies to payments made in 2026, not 2025. This January, you still file 1099s for contractors who received $600 or more. The first filings under the new threshold happen in January 2027.
Read answerWhich of my services and products need sales tax collected?
Professional and medical services are usually exempt from sales tax, while retail products like skincare, supplements, and devices sold at the desk are typically taxable. The exact rules vary by state, especially for borderline items.
Read answerThe IRS sent me a letter. How bad is this?
Probably not as bad as you think. Most IRS letters are notices about a specific question or discrepancy, not audits. Even audit letters describe a defined process with steps and deadlines that can be managed.
Read answerCan one person handle both my business return and my personal return?
Yes, and for pass-through owners it's practically necessary. Your business return generates a K-1 that flows directly onto your personal return. Having one CPA see both sides means better coordination of salary, distributions, and deductions.
Read answerIs December too late to lower this year's taxes?
December is late but not useless. You can still make equipment purchases, establish certain retirement plans, time expenses, and correct estimated payments. January is when the door truly closes.
Read answerWhat does proactive tax strategy actually involve, beyond filing?
Proactive tax strategy shapes your tax outcome before the year ends rather than just reporting what happened. It includes entity and election analysis, salary and distribution design, retirement plan selection, purchase timing, estimate management, and multi-state exposure checks.
Read answerMy business now operates in two states. What did I just get myself into?
Operating in two states means you now have filing obligations in both. You'll likely need to register with the second state, file income tax returns there, and if you have employees or taxable sales in that state, handle payroll withholding and sales tax too.
Read answerI have a feeling my old returns left money on the table. Is it recoverable?
A prior-return review sometimes finds missed deductions, credits, or elections that can be recovered through amended returns filed within about three years of the original deadline. Beyond that window, any findings become forward-looking fixes rather than refunds.
Read answerEveryone in home care argues about 1099 versus W-2 caregivers. What is the truth right now?
Hourly caregivers whose schedules and work an agency controls generally look like employees under the classification tests that matter. The cost of misclassification is severe, including back wages, penalties, and potential personal liability for agency owners.
Read answerWhere do caregiver overtime rules stand right now?
The federal rules are in flux. The DOL has proposed reinstating the companionship exemption for agencies, but the change is not final and many states require overtime regardless. The safe approach is to budget and pay as if overtime applies.
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