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

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We serve school districts on contract. What does that mean for our books?

School district contracts bring specific bookkeeping requirements that differ from private-pay or insurance-based revenue. Each contract you hold with a district carries its own billing rates, invoicing schedule, and payment terms. Your books need to track all of this at the contract level, not just in one lump sum.

The key is tracking revenue through three stages per contract. First, you earn the revenue when you deliver the service. Then you invoice it according to whatever schedule the contract requires. Finally, you get paid when the district processes the invoice and sends the check. Depending on the district, that can take 30, 45, or even 60 days. Your books should show you where each contract stands across all three stages at any given time.

This matters because school district revenue follows the school year, not the calendar year. From September through May, you may have steady work and predictable invoicing. Then summer hits and the revenue stops or slows significantly while your overhead continues. If your books only show cash received, you won’t see this coming until it’s too late. Working with a CPA for medical businesses who understands contract-based revenue helps you see the full picture and plan for the summer months before they arrive.

Vendor compliance paperwork is another piece to track. Districts typically require current certificates of insurance, W-9s, and sometimes background check documentation before they pay invoices. If any of this lapses, payment gets held. Tracking these deadlines alongside the financial data keeps you from getting surprised when a payment doesn’t come through.

The biggest cash lever you control is how promptly you invoice. Districts pay on their schedule once they receive your invoice, so delays on your end mean delays getting paid. If invoicing falls behind by a few weeks, you’ve pushed your cash out by a few weeks. Work that gets billed promptly gets paid sooner.

For therapy practices serving multiple districts, full-service bookkeeping that tracks by contract gives you clarity on which relationships are actually profitable and where cash will be tight. Without this structure, you’re flying blind on both profitability and cash flow.

If you’re serving school districts and want books that show you the real picture, reach out to schedule a consultation.

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More Questions

A 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.

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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.

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How 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.

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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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I 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.

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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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