How it runs for medical practices and clinics
Every deposit is tied to an ERA or patient batch, credit balances are aged as of each month-end, and you receive a clean opening balance with a list of unresolved items and a year-end package.
What is catch-up bookkeeping?
Catch-up bookkeeping is a one-time project that records and reconciles months or years of transactions that were never entered. The goal is a set of books where every bank, card and loan balance agrees with the statement and every period can be reported on. It ends when the backlog is current and reconciled, usually followed by ongoing monthly bookkeeping.
What we handle for medical practices and clinics
- Rebuild revenue from practice-management deposit and adjustment history month by month
- Tie every historical deposit to an ERA batch or patient payment batch
- Re-post payroll and provider compensation from the provider's historical registers
- Age credit balances as of each month-end and quantify the refund liability
- Deliver a clean opening balance and a year-end package for your CPA
The KPI that matters here
Every back month reconciled and reviewed, with the refund liability quantified and open items listed at handover.
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)
- AdvancedMD
- QuickBooks Online
- Gusto
- Bill.com
- Stripe
- athenahealth
- eClinicalWorks
- All 50 platforms
More for medical practices and clinics
Other services for medical practices
Catch-up bookkeeping in other industries
Frequently asked questions
What do you need to rebuild a practice's books?
Bank, card and loan statements, payroll registers, the practice-management system's monthly deposit, adjustment, refund and aging reports, ERA archives from your clearinghouse, and vendor statements from distributors and carriers. Lease and equipment agreements help with the balance sheet. We list what is missing after the first review and work with what is available.
Will a catch-up expose refund obligations?
Usually, yes. Aging credit balances as of each month-end shows how much the practice owes patients and payers and how long it has been owed. That is important information before a sale or buy-in, and it may involve the 60-day overpayment rule for Medicare and Medicaid. We quantify and document it; your counsel advises on reporting obligations.
How long does a practice catch-up take?
It depends on the number of months, locations, bank accounts and payers, and on how complete the practice-management reports are. A single-location practice with clearinghouse ERA archives moves quickly; a multi-location group with a system change midway takes longer. We scope after reviewing your data and run it as a fixed project with weekly progress notes.
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