Our revenue mixes private pay, long-term care insurance, and a Medicaid waiver program. Can your books keep that straight?
Yes. The books track each payer type separately so you can see exactly where revenue comes from, how long it takes to collect, and what your actual margins look like by source.
Private pay, long-term care insurance, and Medicaid waiver programs each behave differently in your finances. Private pay typically arrives at or near the time of service. Long-term care insurance claims have their own approval and payment timelines that vary by carrier. Medicaid waiver reimbursements follow state-specific schedules and rates that often differ from what you charge private-pay clients. When all three get blended into one revenue number, you lose the ability to answer basic questions about your business.
Keeping the books straight means setting up your chart of accounts and tracking so that each deposit gets coded to the correct payer category. At month end, you see revenue broken out by payer type. You see how much is still outstanding from each source and how long those receivables have been sitting. If your costs are allocated properly, you can calculate margin by source and know which payer mix actually makes you money versus which one just keeps you busy.
This visibility matters when you’re deciding whether to take on more waiver clients, whether that LTC insurance carrier is worth the hassle, or how much of your revenue is exposed to reimbursement rate changes you don’t control. Full-service bookkeeping built for this payer mix gives you real numbers to plan around instead of guesses.
The firm handles the accounting side of this work. Hunter Green CPA does not submit claims to insurance companies or waiver programs. We receive the deposit information from your bank, code it to the correct payer source, and reconcile what came in against what you expected. The clinical billing and claims submission stays with you or your billing service. Bookkeeping for medical businesses like yours requires understanding both the accounting and the boundaries of the work.
If your books currently show one blended revenue number and you want to see the real breakdown by payer type, that’s a solvable problem. Book a consultation and we can talk through how to structure the tracking for your specific payer mix.
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.
More Questions
What separates a profitable therapy practice from a busy one?
The difference is per-visit economics. A profitable practice tracks collected revenue, clinician cost, and overhead per visit by clinician and service type. A full schedule at weak rates is busyness, not profit.
Read answerWhy is ABA practice bookkeeping its own animal?
ABA practices have a financial structure unlike most other medical businesses. Hourly behavior technician payroll dominates expenses, authorization gating controls when revenue can even exist, and receivables run long while payroll goes out every week.
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 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 answerWhat is a medical director fee and how should it be recorded?
A medical director fee is compensation paid to a supervising or sponsoring physician for clinical oversight. It should be recorded in the correct entity, match the documented agreement, and stay consistent month to month.
Read answerWho can see my financial information when I work with you?
Your financial information is seen by the team members actively working on your engagement. Data lives in reputable cloud accounting systems with controlled access, and CPAs carry professional confidentiality obligations.
Read answer

