How it runs for DME and HME suppliers
The billing system keeps patient-level detail. The ledger carries clean totals your CPA and lender can rely on.
What is outsourced bookkeeping?
Outsourced bookkeeping means a remote accounting team records, categorizes and reconciles your business transactions instead of an employee doing it in-house. You keep ownership of the accounting file and the bank relationship. The provider works inside your software on a fixed schedule, so the books are ready for reporting, tax and lending whenever you need them.
What we handle for DME and HME suppliers
- Monthly Brightree or Bonafide revenue, adjustment and cash summaries posted by payer class
- Product-line classes for respiratory, mobility, sleep resupply, wound care and retail
- Rental fleet and serialized equipment capitalized, depreciated monthly and retired when lost
- Manufacturer, distributor and oxygen-fill bills coded to the correct cost line
- Weekly open-items list covering unposted deliveries and missing invoices
The KPI that matters here
Zero uncategorized transactions older than seven days and books closed within five business days of month-end.
DME & HME compliance notes
Medicare DMEPOS supplier rules
Medicare DMEPOS suppliers must meet the supplier standards, hold accreditation and keep a surety bond to bill Medicare. Payment then follows fee schedules, competitive-bid amounts and capped-rental rules that decide when revenue is earned. Your books need to reflect those payment rules, not a generic sales model.
Prior authorization
CMS keeps a Required Prior Authorization List for certain DMEPOS items, and claims for those items without an affirmed decision are denied. We flag delivered-but-unauthorized orders as unbilled at each close so cash forecasts stay honest. Authorization work itself stays with your intake or billing team.
HIPAA
Patient names and diagnoses appear on remittances, statements and Brightree exports. Our staff are HIPAA-trained, we sign a BAA, access is logged and files are never downloaded to local devices.
State sales tax on equipment
Many states exempt prescribed durable medical equipment from sales tax while taxing retail accessories and over-the-counter items. We track taxable and exempt sales separately in the ledger so returns can be prepared from the books. Your tax preparer or advisor confirms the rules for each state.
DME & HME software we work in
- QuickBooks Online
- Sage Intacct
- Bill.com
- Gusto
- Brightree
- Bonafide
- TIMS Software
- All 50 platforms
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Frequently asked questions
Why should DME revenue be posted from the billing system rather than from bank deposits?
Because deposits arrive weeks after delivery and net of payer adjustments. Posting revenue from Brightree or Bonafide summaries records gross charges in the delivery month, contractual adjustments as their own line and cash when it lands. That gives you a true gross margin and an AR balance that agrees with your billing system, which deposit-based posting never can.
How do you treat rental equipment in the books?
Rental concentrators, beds, wheelchairs and CPAP units are capitalized as fixed assets and depreciated monthly over their useful life. When a unit is returned and redeployed nothing changes; when a unit is lost or scrapped we retire it and write off the remaining value. Resupply and retail stock stays in inventory and moves to cost of goods when shipped.
Can the books show each branch separately?
Yes. We set up locations or classes for each branch in QuickBooks Online, or dimensions in Sage Intacct, and map the billing-system branch codes to them. Shared costs such as billing staff and software are allocated on a rule you approve. You then get a P&L per branch and a consolidated view without running two files.
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