How it runs for home care and home health agencies
Your named accountant categorizes bank and card activity, books the Gusto or ADP payroll journal by department, records mileage reimbursements and background-check fees, and keeps a claims-clearing account that ties to your open-claims report. Books are reconciled monthly and reviewed by a second accountant before you see them.
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 home care and home health agencies
- Post revenue by payer from verified-visit exports, never from bank deposits
- Book caregiver payroll journals split between billable care and office wages
- Maintain a claims-clearing account that ties to the open-claims report
- Record mileage, background checks, training and PPE as separate expense lines
- Reconcile private-pay retainers and deposits held on account for families
The KPI that matters here
Books closed by the fifth business day with the claims-clearing account fully tied to the billing system.
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
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- AxisCare
- WellSky
- Alora
- HHAeXchange
- All 50 platforms
More for home care and home health agencies
Other services for home care
Frequently asked questions
Why do you post revenue from the scheduling system instead of bank deposits?
Because one MCO deposit can cover visits from three different months and a dozen clients. Posting from the verified-visit export records revenue in the month the care happened, at the contracted rate, by payer. The deposit is then matched to those receivables, and any short pay or recoupment shows up as a difference to work rather than a mystery in cash-basis income.
How are caregiver wages coded in the books?
Caregiver wages, overtime and payroll taxes are coded to cost of care so gross margin per billable hour is visible on the P&L. Office staff, schedulers and the owner's salary sit in operating expenses. If your payroll provider exports by department, we map those departments once and the split repeats every pay period without manual work.
What do you need from us each month?
Report access in your scheduling and billing platform, accountant access to QuickBooks Online or Xero, read-only bank feeds and the payroll register. Most agencies also forward vendor bills to a shared inbox. We send a weekly note listing anything missing, such as an unexplained deposit or a receipt for a supply purchase, so the close does not stall.
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