Bookkeeping and tax for medical businesses • Personal tax returns for individuals

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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.

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More Questions

Which 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.

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Bookkeeper, accountant, CPA: who do I actually need?

Bookkeepers record transactions, accountants organize financial data, and CPAs are licensed to sign returns and provide tax strategy. For medical business owners, the best structure is often CPA-level oversight applied to the bookkeeping itself, so the books are built with the return in mind all year.

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How do I know if my practice can support a second clinician?

You need three things to line up: proven demand beyond your current capacity, projected revenue from the new hire that comfortably exceeds their fully loaded cost, and enough cash to carry them through the ramp-up months before their schedule fills.

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What should an hour of care actually cost me to deliver?

An hour of care costs far more than the caregiver's wage. Add employer payroll taxes, workers comp, travel time, training, and unbilled gaps, and the fully loaded cost can run 30 to 50 percent above the wage itself.

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Which treatments on my menu are actually profitable?

Profitability at the treatment level requires tracking product consumed, provider compensation, and device or room costs against each service's price. Many owners discover their marquee treatments barely break even while simpler services quietly carry the month.

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The 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.

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Hunter Green CPA provides bookkeeping, tax preparation, and tax strategy for medical business owners across the United States. Alongside its business services, the firm prepares personal tax returns for individuals and families. Based in Oak Park, Illinois and led by Mason Hunter, a CPA with 10 years of tax experience and a background in corporate tax management.

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