How it runs for NEMT and medical transportation companies
Vehicle loans are split into principal and interest, depreciation is booked monthly from the fixed-asset register, and every bank and card account is reconciled before a second accountant reviews the close. The result is a P&L that shows margin by broker and cost per loaded mile.
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 NEMT and medical transportation companies
- Post revenue by broker and trip type from completed-trip reports each week
- Code fuel-card, toll, maintenance and insurance transactions to the vehicle that incurred them
- Book driver pay by type: hourly, per-trip and owner-operator settlements
- Split vehicle loan payments into principal and interest and book monthly depreciation
- Reconcile operating, payroll and fuel-card accounts with a monthly exception list
The KPI that matters here
Books closed by the fifth business day with revenue by broker tied to the dispatch system's completed-trip totals.
NEMT compliance notes
Broker contracts (Modivcare, MTM and regional brokers)
Each broker contract defines rate tables by trip type and mileage band, documentation required for payment, the dispute window and audit rights. We keep the current rate table in the billing workflow, check remittances against it, and log every dispute with its deadline so revenue is not lost to a missed date.
HIPAA
Trip records identify riders, pickup addresses and often the treating facility, which makes them protected health information. We sign a BAA, staff are HIPAA-trained, portal access is role-limited with MFA, and ledger entries reference trip or invoice numbers rather than rider names.
State Medicaid NEMT rules
States set driver background-check, vehicle inspection, trip-log and record-retention requirements for Medicaid transportation, and brokers pass those obligations through their contracts. We file supporting cost records so a state or broker audit can be answered from the books, and we flag lapses in insurance or inspection renewals that would suspend billing.
Worker classification
How drivers are paid and controlled determines whether they are employees or contractors under IRS and state tests. We book pay according to the classification you and your counsel have chosen, track 1099 settlements separately from W-2 payroll, and prepare the year-end 1099-NEC data for owner-operators.
NEMT software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- TripMaster
- RouteGenie
- Modivcare provider portal
- MTM provider portal
- All 50 platforms
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Frequently asked questions
How do you post revenue when brokers pay weeks after the trip?
Revenue is recorded when the trip is completed, at the contracted rate from the broker's rate table, so each month shows the work actually done. The broker's later payment is applied against that receivable. The difference between what was earned and what was paid becomes the remittance variance you chase, instead of being hidden by recording revenue only when cash arrives.
Why code expenses by vehicle instead of one fuel account?
Because one number for fuel tells you nothing about which vehicle or which route is losing money. Coding fuel, maintenance, tires, tolls and insurance to each unit produces cost per loaded mile by vehicle and lets you compare a stretcher van to an ambulatory sedan. It also gives you the data to decide when to replace a unit.
What is in the fixed-asset register?
Each vehicle's purchase date and price, financing details, accumulated depreciation, and the depreciation method your tax preparer specified. Lifts, radios and tablets above your capitalization threshold are included. The register drives the monthly depreciation entry and gives your CPA a clean schedule at year-end instead of a list of loan payments to untangle.
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