--- title: "Outsourced bookkeeping for medical practices & clinics" description: "Outsourced bookkeeping for medical practices & clinics: dedicated remote bookkeepers categorise, reconcile and close your books in QuickBooks Online." url: https://ledgerbpo.com/industries/medical-practices/bookkeeping/ updated: 2026-09-11 publisher: LedgerBPO (SS Support Network LLC) language: en-US --- # Outsourced bookkeeping for medical practices & clinics Outsourced bookkeeping for medical practices & clinics is a reconciliation job before it is a categorization job. The practice-management system holds charges, contractual adjustments, payer payments, patient payments and refunds; the bank holds deposits that combine ERAs, portal payments and card-on-file batches. Your named accountant posts the practice-management activity to the ledger in summary, ties the deposit report to the bank, books payroll and physician compensation from Gusto or ADP, records drug and vaccine purchases, malpractice premiums, lease and equipment loans, and keeps a claims-clearing account that agrees with the aging by payer. - Since 2020 - US · UK · CA · AU - Named accountant plus backup - Your software, no lock-in [Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) [Book a 20-minute call](https://ledgerbpo.com/book-a-call/) Updated September 2026 ## How it runs for medical practices and clinics Every account is reconciled and reviewed by a second accountant each month. ## 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 medical practices and clinics - Post practice-management charges, adjustments, payments and refunds to the ledger monthly - Tie the deposit report to bank deposits including ERA, portal and card batches - Book payroll and physician compensation by provider from the payroll register - Record vaccine, drug and supply purchases as cost of services, not overhead - Maintain a claims-clearing account that agrees with the aging by payer ## The KPI that matters here Books closed by the fifth business day with the practice-management aging tied to the balance-sheet receivable. ## Medical practices compliance notes ### HIPAA Claims, remittances and patient statements are protected health information. We sign a BAA, staff are HIPAA-trained, access to your practice-management system is role-limited with MFA, and ledger entries carry claim or batch numbers rather than patient names or diagnoses. ### Payer rules and timely filing Every payer contract sets timely-filing limits, appeal windows, coordination-of-benefits rules and refund procedures. Medicare allows 12 months from the date of service to file; many commercial payers allow less. We log deadlines per payer so unpaid claims are worked before they age out. ### Overpayment refunds Identified Medicare and Medicaid overpayments must be reported and returned within 60 days of identification under the Affordable Care Act. We age credit balances by payer, prepare refund batches for your approval, and document the dates so the practice can show it acted in time. ### Patient credit balances and unclaimed property Patient overpayments that go unrefunded may become reportable unclaimed property under state law after a dormancy period. We list patient credits monthly, prepare refunds for your approval, and keep records that support any state filing your counsel advises. ## Medical practices software we work in - [Kareo (Tebra)](https://ledgerbpo.com/software/kareo-tebra/) - [AdvancedMD](https://ledgerbpo.com/software/advancedmd/) - [QuickBooks Online](https://ledgerbpo.com/software/quickbooks-online/) - [Gusto](https://ledgerbpo.com/software/gusto/) - [Bill.com](https://ledgerbpo.com/software/bill-com/) - [Stripe](https://ledgerbpo.com/software/stripe/) - athenahealth - eClinicalWorks - [All 50 platforms](https://ledgerbpo.com/software/) ## More for medical practices and clinics Other services for medical practices - [Invoicing and billing](https://ledgerbpo.com/industries/medical-practices/invoicing-and-billing/) - [Accounts receivable](https://ledgerbpo.com/industries/medical-practices/accounts-receivable/) - [Accounts payable](https://ledgerbpo.com/industries/medical-practices/accounts-payable/) - [Bank reconciliation](https://ledgerbpo.com/industries/medical-practices/bank-reconciliation/) - [Month-end close](https://ledgerbpo.com/industries/medical-practices/month-end-close/) - [Financial reporting](https://ledgerbpo.com/industries/medical-practices/financial-reporting/) - [All medical practices services](https://ledgerbpo.com/industries/medical-practices/) Bookkeeping in other industries - [Marketing agencies & consultancies](https://ledgerbpo.com/industries/agencies/bookkeeping/) - [Auto repair shops & dealerships](https://ledgerbpo.com/industries/auto/bookkeeping/) - [Behavioral health practices](https://ledgerbpo.com/industries/behavioral-health/bookkeeping/) - [Daycares, schools & education](https://ledgerbpo.com/industries/childcare-education/bookkeeping/) - [The full bookkeeping page](https://ledgerbpo.com/services/bookkeeping/) ## Frequently asked questions ### Why post the practice-management system in summary rather than claim by claim? Claim-level detail lives in the practice-management system, which is the system of record for patient accounts. The general ledger needs the totals: charges, contractual adjustments, payments by source and refunds, tied to the bank. Posting in summary keeps patient information out of the ledger and keeps the two systems in agreement without duplicating every transaction. ### How are vaccines and drugs handled in the books? Purchases are coded to cost of services rather than general supplies so gross margin on injectables and in-office procedures is visible. Where the practice carries meaningful inventory, we book a periodic count adjustment. Manufacturer rebates and distributor credits are recorded against the purchase account so the true cost of each product is clear. ### What do you need from the practice each month? Report access in your practice-management system, accountant access to QuickBooks Online or Xero, read-only bank and card feeds, the payroll register and a shared inbox for vendor bills. We send a weekly list of open questions, such as an unmatched deposit or a missing distributor invoice, so nothing waits until month-end to be resolved. Next step ## Books closed. Invoices paid. Every month. Tell us what is going on with your books or billing. You will hear from a named person within 1 business day, with a custom quote and a plan for the first close. - Reply from a named person within 1 business day - No setup fee, month-to-month - Your software, your data, no lock-in Start with a custom quote [Book a billing audit](https://ledgerbpo.com/book-a-call/?topic=billing-audit) [Book a 20-minute call](https://ledgerbpo.com/book-a-call/) Or call [+1-657-777-0006](tel:+16577770006) during US, UK or Australian business hours. --- Source: https://ledgerbpo.com/industries/medical-practices/bookkeeping/ · Contact: https://ledgerbpo.com/contact/ · Full site map for agents: https://ledgerbpo.com/llms.txt