How it runs for home care and home health agencies
Every balance-sheet account is reconciled, the aging by payer is tied to the ledger, and a second accountant signs off under Two-Tier Review before your financials are released, usually by the fifth business day.
What is month-end close outsourcing?
Month-end close outsourcing means an external accounting team performs the steps that turn a month of transactions into finished financial statements: reconciling every account, posting accruals, prepaids and depreciation, checking cut-off, reviewing and locking the period. You keep your software and your accountant. The provider runs the checklist on an agreed calendar and hands you reviewed statements.
What we handle for home care and home health agencies
- Accrue delivered-but-unclaimed visits at contracted rates at month-end
- Accrue caregiver wages for days between the last pay period and month-end
- Tie the aging by payer to the balance-sheet receivable each month
- Reconcile the claims-clearing account to the billing platform's open-claims report
- Sign off every close with a maker-checker review and a documented log
The KPI that matters here
Financials released by the fifth business day with every balance-sheet account reconciled and signed off.
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 accrue visits that have not been claimed yet?
Because care delivered in March is March revenue even if the EVV exception is cleared and claimed in April. Without the accrual, months with billing delays look weak and later months look strong for the wrong reason. We accrue at the contracted rate for verified visits awaiting claim and reverse the accrual when the claim is posted.
How do you handle payroll that straddles month-end?
We accrue caregiver and office wages for the days worked after the last pay period but before month-end, using the timesheet hours and average rates from the payroll register. The accrual reverses on the first of the next month. This keeps labor cost aligned with the revenue it produced and stops a three-payroll month from distorting your margin.
What does the close package contain?
A P&L by payer and by location if you have several, a balance sheet with every account reconciled, an aging by payer tied to the ledger, a cash summary, and a short note on what moved and why. The CloseTrack log shows who prepared and who reviewed each step, which lenders and state surveyors find reassuring.
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