Industry focus
Medical Practice Accountant for Physicians
From dental offices, physician groups, home health agencies, telemedicine platforms, nurse practitioners, and independent doctors: we handle your payroll, entity structuring, and tax strategy so you can focus on your patients, not the IRS.
How we work with this industry
Medical practices carry a payroll problem before they carry a tax problem. Associate physicians, per diem nurses, billing staff and contracted specialists all get paid differently, and the entity you chose at formation sets the rules for how much of that can reach you as distribution rather than salary. We handle the books, the payroll filings and the year-round planning so the return is a formality rather than a scramble.
The revenue side needs the same attention. Payers deposit a net amount after contractual adjustments, takebacks and denied claims, so the money that lands in the bank is not the money you billed. We reconcile remittances against deposits every period, keep the adjustments visible as adjustments, and record patient copays and card processing fees where they belong, so collection performance is something you can read rather than guess.
The rest is cadence. Equipment purchases, a new operatory, a provider added mid-year and owner compensation all change the tax picture, and each of them is easier to plan before it happens than to explain afterward. We close the books monthly, keep the payroll and information returns on their own calendar, and talk with you during the year so the return reflects decisions you actually made.
What We Do
What We Handle for Medical and Dental Practices
The recurring work behind a practice, from the pay runs to the return, handled on a schedule you can plan around.
Payroll for Mixed Clinical Teams
Pay runs for W-2 staff alongside contracted providers, with Form 941, Form 940 and Florida reemployment tax filed on their own schedule. Contractor payments are tracked by payee through the year so the information returns are complete.
Insurance Remittance Reconciliation
Payer deposits tied back to the remittance advice and to the bank, so contractual adjustments, denials and takebacks stay visible instead of quietly shrinking revenue.
QuickBooks Built for a Practice
A chart of accounts that separates clinical supplies, lab fees, provider compensation and facility cost, set up by a QuickBooks ProAdvisor and split by location or provider when you need to read them apart.
Owner Compensation and Entity Structure
Salary and distribution reviewed against what the practice actually earns, so the split is defensible and revisited as the practice grows rather than left at whatever was set at formation.
Equipment, Buildout and Depreciation
Chairs, imaging, sterilization and leasehold improvements coded correctly the first time, with the capitalize or expense decision made before the purchase rather than reconstructed at year end.
Practice and Personal Returns Together
The entity return, the K-1 and your individual return prepared as one piece of work, so estimated payments reflect what the practice is actually distributing to you.
Common Problems
Where Medical Practice Books Go Wrong
Four failures we find in almost every practice file we inherit.
Net Deposits Recorded as Revenue
Booking the payer deposit as the sale erases the contractual adjustment and the denial behind it. The practice then has no way to see what it collects against what it bills, which is the one number that governs a clinical business.
Providers Classified by Convenience
A per diem nurse or associate who is scheduled, supervised and worked into the practice routine is not automatically a contractor because the payment was made that way. Classification is decided by the working relationship, and it is cheaper to review it now than after a notice.
Owner Salary Set Once and Forgotten
If the practice is taxed as a corporation, compensation chosen when there was one provider and never revisited is exposure. The IRS can recharacterize distributions as wages where the wage was never reasonable for the work, so the figure has to track what the practice earns and what the work is worth, and that changes as you add providers.
One Account for Practice and Personal
Licensure, continuing education, malpractice coverage and personal spending running through the same account turns every deduction into an argument. Separate accounts make the same expenses provable without any additional effort.
Services we offer in this industry
The services most often used by businesses in this industry. Each one is led by an Enrolled Agent.
Related industries
Trucking & Transportation
Owner-operators, fleet companies, freight brokers, courier services, and logistics providers: we handle IFTA, per diem, Sec. 179 depreciation, and 1099 driver compliance, keeping your operation road-ready and audit-proof.
Sports, Fitness & Wellness
Gyms, sports academies, personal trainers, coaches, yoga studios, and nutrition consultants: we put the S-Corp election to work for you, cutting self-employment taxes and maximizing every deduction in your playbook.
Agriculture & Landscaping
Farms, nurseries, lawn care companies, tree services, and irrigation contractors: we file your Schedule F, capture fuel tax credits, and manage seasonal payroll so your business grows as well as your crops.
Related guides
S-Corp Reasonable Compensation: 7 Court Cases the IRS Cites
S-corp shareholder-employees who perform more than minor services must be paid a reasonable salary subject to FICA, FUTA, and income tax withholding. Here is the IRS rule, the Watson standard, and the seven decisions the agency cites.
100% Bonus Depreciation Is Permanent: 2026 Section 179 Cap $2,560,000
Public Law 119-21 made the 100% first year deduction permanent for qualified property acquired after January 19, 2025, and set the 2026 Section 179 cap at $2,560,000 with the phase down starting at $4,090,000.
Common questions
Questions we hear in this industry
Straight answers, from an Enrolled Agent.
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