How it runs for medical practices and clinics
The controller prepares lender and buy-in packages, models a new provider hire or a location opening, supports your CPA at year-end, and holds a monthly call on cash, compensation and payer mix.
What are outsourced controller services?
Outsourced controller services provide the review layer that sits between bookkeeping and the owner: a senior accountant who checks the close, owns the accounting policies, tests the controls around cash and spending, and explains the financial statements. The controller does not do daily posting. They make sure what was posted is right and documented before anyone relies on it.
What we handle for medical practices and clinics
- Review each close for encounter cut-off, accruals and fee-schedule accuracy
- Model a new provider hire, location opening or payer contract before you commit
- Prepare lender, partner buy-in and practice-sale financial packages
- Own the close calendar and the compensation calculation review
- Hold a monthly call with the managing partner on cash, compensation and payer mix
The KPI that matters here
Every close reviewed and signed off by the controller with a written summary of exceptions and decisions needed.
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
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Frequently asked questions
When does a practice need a controller rather than a bookkeeper?
When partners are making hiring, location or contract decisions on unreconciled reports, when a lender or buyer requires reviewed monthly financials, or when compensation disputes recur because nobody owns the numbers. The controller adds judgment and review on top of the bookkeeping already in place, at a fraction of the cost of an employee.
Can the controller help with a partner buy-in or practice sale?
Yes. We prepare reconciled historical financials, normalize owner compensation and one-time items into a schedule the valuation accountant can use, quantify credit balances and refund liabilities, and answer diligence questions from the books. The valuation and legal terms are for your advisers; we make sure the numbers they rely on are right.
How does the controller model a new provider?
We take the expected visit volume and payer mix, apply your actual net collections per visit by payer, and compare that to the provider's compensation, malpractice, staff and space costs. The result is a monthly break-even and a ramp timeline you can test against different assumptions. It is analysis to support your decision, not a recommendation to hire.
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