How it runs for medical practices and clinics
After the run we book the journal by provider and location, reconcile the clearing account, and track retirement-plan contributions, malpractice deductions and other liabilities until they are remitted.
What is payroll processing outsourcing?
Payroll processing outsourcing means a remote team prepares each pay run inside your payroll software: reconciling hours, entering changes, checking deductions and producing the run for the employer to approve. The employer keeps the payroll account, the bank authority and the legal responsibility. The provider posts the payroll journal and reconciles it, so payroll and the books agree.
What we handle for medical practices and clinics
- Assemble clinical and administrative hours with shift differentials and overtime applied
- Enter provider productivity or collections bonuses from reconciled compensation data
- Book payroll journals by provider and location and reconcile the clearing account
- Track retirement-plan, benefit and malpractice deductions until remitted
- Reconcile quarterly payroll tax filings to the ledger
The KPI that matters here
Payroll register reviewed and approved before each run, with the journal posted by provider and location within two business days.
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
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Frequently asked questions
Do you run the payroll or support it?
We prepare and review each run inside your payroll provider and you approve it; the provider pays staff and remits taxes. We never move money. Our part is the hours assembly, differential and overtime checks, provider compensation entries, the journal by provider and location, and the reconciliation of the clearing account and quarterly filings.
How do you handle physician productivity bonuses?
The bonus is calculated from data that has already been reconciled: collections by provider tied to the bank or wRVUs from the practice-management system, applied to the formula in your compensation agreement. The calculation is documented, reviewed by a second accountant, and entered into payroll for your approval. We apply the agreement; we do not design it.
What payroll liabilities matter most in a practice?
Retirement-plan contributions, which have deposit deadlines, employer payroll taxes, benefit deductions, and any provider-specific deductions for malpractice or CME your agreement requires. We track each as a liability until remitted and reconcile the provider's quarterly filings to the ledger so the balance sheet shows what is truly owed at any point.
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