Accounting software setup & migration for home care & home health agencies

QuickBooks setup for home care & home health agencies is mostly about the chart of accounts and the map between your scheduling platform and the ledger. We design accounts for revenue by payer, cost of care by caregiver type, and the clearing accounts that tie AxisCare, WellSky, Alora or HHAeXchange to QuickBooks Online or Xero.

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How it runs for home care and home health agencies

Classes or tracking categories are set up for branches, the payroll provider is mapped by department, and bank feeds and rules are configured so recurring items post correctly. If you are moving from spreadsheets or QuickBooks Desktop, we migrate opening balances, historical aging and vendor lists, and run one month in parallel before cut-over.

What is accounting software setup and migration?

Accounting software setup is the configuration of a new ledger: chart of accounts, tax codes, bank feeds, items, users and apps. Migration is moving existing books from another platform or spreadsheet into that ledger so history, open items and balances carry across. Both end with a file that agrees to the old records and is ready for live posting.

What we handle for home care and home health agencies

  • Design a chart of accounts with revenue by payer and cost of care by caregiver type
  • Map the scheduling platform's billing export to ledger accounts and clearing accounts
  • Set up classes or tracking categories for branches and states
  • Configure payroll provider mapping by department and bank-feed rules
  • Migrate opening balances, aging and vendors with one parallel month before cut-over

The KPI that matters here

Cut-over completed with opening balances tied to the prior system and the first close delivered on schedule.

Home care compliance notes

EVV

The 21st Century Cures Act requires electronic visit verification for Medicaid personal-care and home-health visits, captured through state aggregators such as HHAeXchange or Sandata. We bill only from verified visits and keep an exception log for visits that need a manual correction before they can be claimed.

HIPAA

Client names, diagnoses and authorizations are protected health information. We sign a BAA, our staff are HIPAA-trained, access is limited to the roles that need it, and PHI never appears in ledger memos or emailed spreadsheets.

State Medicaid and MCO rules

Each state waiver and each managed-care organization sets its own authorization limits, unit rounding, timely-filing window and recoupment process. We track authorizations against billed units and record recoupments as reductions to the original claim, not as unexplained bank debits.

FLSA Home Care Rule

Most agency caregivers are entitled to minimum wage and overtime, and travel time between clients counts. Your payroll provider computes the pay; we make sure the ledger and the labor-cost reports reflect it correctly and that live-in and sleep-time arrangements are coded as your counsel directs.

Home care software we work in

More for home care and home health agencies

Frequently asked questions

How should a home care agency's chart of accounts be organized?

Revenue by payer type, cost of care separated from office payroll, and distinct lines for mileage, screening, training, PPE and supplies. Add clearing accounts for claims and for the card processor, and classes for branches. This structure produces gross margin per billable hour and payer profitability directly from the ledger, without a spreadsheet rebuild each month.

Can our scheduling platform sync directly to QuickBooks Online?

Several home care platforms offer a QuickBooks Online sync for invoices and payments. Where yours does, we configure the mapping and reconcile the results monthly so duplicates and mis-mapped items are caught. Where it does not, we post from the platform's billing export on a fixed schedule. Either way, the platform remains your system of record for visits.

Should we choose QuickBooks Online or Xero?

Both work well for agencies. QuickBooks Online is more common in the US and integrates with most home care platforms and payroll providers. Xero is strong in the UK, Canada and Australia and has clean tracking categories for branches. We recommend whichever your scheduling platform and payroll provider integrate with best, and we work in either.

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