--- title: "Month-end close for medical practices & clinics" description: "Month-end close for medical practices & clinics: outsourced month-end close: checklist-driven accruals, prepaids, depreciation, reconciliations and a." url: https://ledgerbpo.com/industries/medical-practices/month-end-close/ updated: 2026-09-11 publisher: LedgerBPO (SS Support Network LLC) language: en-US --- # Month-end close for medical practices & clinics A trustworthy month end close for medical practices & clinics means revenue reflects encounters in the month they occurred, net of contractual adjustments, and the receivable on the balance sheet equals the practice-management aging. Our CloseTrack checklist runs an encounter cut-off, reconciles the claims-clearing account, accrues payroll for days after the last pay period, books malpractice and other prepaid expenses evenly, records equipment depreciation, and ages credit balances into a refund liability. - 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 Each balance-sheet account is reconciled and a team lead reviews under Two-Tier Review before the package is released by the fifth business day with a P&L by provider or location. ## 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 medical practices and clinics - Run an encounter cut-off and reconcile the claims-clearing account to the aging - Accrue payroll and provider compensation for days after the last pay period - Spread malpractice premiums and prepaid subscriptions evenly across months - Move aged credit balances into a refund liability before financials are issued - Sign off every close with a maker-checker review and a written log ## The KPI that matters here Close released by the fifth business day with the practice-management aging equal 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 - [Bookkeeping](https://ledgerbpo.com/industries/medical-practices/bookkeeping/) - [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/) - [Financial reporting](https://ledgerbpo.com/industries/medical-practices/financial-reporting/) - [All medical practices services](https://ledgerbpo.com/industries/medical-practices/) Month-end close in other industries - [Marketing agencies & consultancies](https://ledgerbpo.com/industries/agencies/month-end-close/) - [Auto repair shops & dealerships](https://ledgerbpo.com/industries/auto/month-end-close/) - [Behavioral health practices](https://ledgerbpo.com/industries/behavioral-health/month-end-close/) - [Daycares, schools & education](https://ledgerbpo.com/industries/childcare-education/month-end-close/) - [The full month-end close page](https://ledgerbpo.com/services/month-end-close/) ## Frequently asked questions ### Should a medical practice keep accrual or cash books? Many practices file taxes on a cash basis, but management decisions need accrual information: charges net of adjustments in the month of service, and receivables that mean something. We can keep accrual books for management and provide cash-basis reports for your CPA, or keep cash books with accrual memo schedules. The choice is made with your tax preparer. ### How are malpractice premiums handled at month-end? A quarterly or annual premium is recorded as a prepaid expense and released evenly each month, so the month the premium is paid does not look like a bad one. Where premiums are provider-specific and your compensation formula charges them to the provider, we tag the monthly expense to that provider so the quarterly calculation is accurate. ### What does the close package contain for a practice? A P&L by provider and by location, a balance sheet with every account reconciled, an aging by payer tied to the ledger, a credit-balance and refund summary, a cash summary and a short note on what changed and why. The CloseTrack log records who prepared and reviewed each step, which partners and lenders find easier to trust. 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/month-end-close/ · Contact: https://ledgerbpo.com/contact/ · Full site map for agents: https://ledgerbpo.com/llms.txt