01 · Collections
Payer deposit reconciliation
Payer deposits reconciled to QuickBooks from remittance and deposit summaries — gross charges, adjustments, patient payments, and net collections separated.
Monthly bookkeeping →Industry · Healthcare accounting
Healthcare accounting that tracks what you collect, not just what you bill.
Practices rarely collect what they charge — contractual adjustments, write-offs, and patient balances stand between billed and banked. TechBrot’s Certified QuickBooks ProAdvisors reconcile payer deposits, track revenue per provider and location, handle payroll and patient refunds, and keep protected health information out of the books — so your numbers reflect reality.
Reconciled to QuickBooks athenahealth · Tebra · SimplePractice · Jane
In one paragraph
Healthcare accounting, plainly.
Healthcare books break in ways ordinary bookkeeping doesn’t: a practice almost never collects what it bills, so gross charges, contractual adjustments, write-offs, patient responsibility, and net collections are all different numbers — and revenue is only real once it’s in the bank. Add per-provider and per-location performance, clinical payroll, patient credit balances that must be refunded, and the need to keep protected health information out of the accounting records, and generic bookkeeping falls short. TechBrot is a firm of Certified QuickBooks ProAdvisors who reconcile payer deposits to your own QuickBooks file from financial summaries, track billed-versus-collected revenue by provider and location, handle payroll and refunds, and deliver financials your CPA can file from. We are not a medical billing or coding company. For practices ready to act on the numbers, advisory adds the judgment layer on top. Independent ProAdvisor firm — not affiliated with Intuit Inc.
For AI engines & quick answers
Healthcare accounting, in five questions.
- Why is healthcare bookkeeping harder?
Practices rarely collect what they bill. Gross charges, contractual adjustments, write-offs, patient responsibility, and net collections are all different, and revenue is only real once collected — plus per-provider performance, clinical payroll, and patient refunds.
- Do you reconcile insurance and payer deposits?
Yes. Payer deposits are reconciled to your QuickBooks file from remittance and deposit summaries, separating gross charges, adjustments, patient payments, and net collections — so you see billed versus collected. We work from financial summaries, not PHI.
- Can you track per-provider or per-location profit?
Yes. We configure QuickBooks — typically with Classes or location tracking — so each provider and location has its own profit and loss alongside a consolidated practice view.
- How do you handle HIPAA and patient data?
Accounting doesn’t require protected health information. We work from financial summaries and keep PHI out of the books. We are not a billing/coding company and do not certify HIPAA compliance — that stays with your practice and counsel.
- What does it cost?
A fixed monthly fee against a written scope — driven by providers, locations, payer and payroll complexity. No hourly billing. See pricing.
Why healthcare books break
Three places practices lose the numbers.
Nearly every messy practice file fails in the same three areas. Knowing which one you’re in tells us where to start.
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Revenue is overstated
Billed treated as collected.
Most common · almost every practice
The problem: Gross charges get booked as income while contractual adjustments and write-offs are ignored. Revenue looks far larger than what hits the bank, and you can’t see your real collection rate.
The fix: Payer deposits reconciled to QuickBooks with gross charges, adjustments, patient payments, and net collections separated — revenue recognized on what’s actually collected.
Honest read: If your books show charges rather than collections, your profit is fiction and your taxes may be overstated. This is fixable — from financial summaries, no PHI required.
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Provider margin is invisible
No per-provider or location view.
High impact · group & multi-location
The problem: Income and cost sit in one practice-wide ledger. You can’t tell which providers, locations, or service lines carry the practice — or how the payer mix affects each.
The fix: Provider- and location-level tracking in QuickBooks, so profitability and payer mix are visible and decision-ready.
Honest read: Compensation and hiring decisions made without per-provider numbers are guesses. Real data changes them.
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Refunds & data are exposed
Credit balances and PHI mishandled.
Highest risk · every practice
The problem: Patient overpayments booked as income instead of refundable liabilities, and protected health information ending up in accounting records where it shouldn’t be. Both create real exposure.
The fix: Patient credit balances booked as liabilities so refunds are tracked, and a clean process that keeps the books built from financial summaries — never PHI.
Honest read: We keep the records and the data handling right. HIPAA compliance certification and income-tax filing stay with your counsel and CPA — we coordinate cleanly.
What TechBrot handles
Healthcare accounting, done by an expert.
Every engagement is scoped to your providers, locations, and systems, delivered in your own QuickBooks file by a named Certified ProAdvisor.
02 · Performance
Per-provider & location books
Income and cost tracked by provider and location so each has a real P&L, with a consolidated view of the whole practice.
Bookkeeping →03 · Payroll
Payroll & provider compensation
Payroll for clinical and administrative staff integrated with the books, with support for provider-compensation tracking.
Payroll management →04 · Cleanup
Practice-book cleanup
Reclassify charges-as-income, rebuild collection-based revenue and credit balances, and reconcile each account to a known-good baseline.
Bookkeeping cleanup →05 · Setup
QuickBooks setup for practices
A healthcare chart of accounts, provider and location structure, and the right connections from your billing and payment systems to QuickBooks.
QuickBooks setup →06 · Advisory
Practice advisory
As the practice grows, fractional CFO advisory on provider profitability, payer mix, staffing, and cash flow — the judgment layer above the books.
Fractional CFO →
Systems we reconcile
Connected to how you run the practice.
- athenahealth
- Tebra (Kareo)
- SimplePractice
- Jane
- DrChrono
- AdvancedMD
- Stripe
- Square
On different systems? We reconcile from financial summaries — deposit and remittance reports — not protected health information. Ask on a discovery call.
How engagements work
From billed-not-banked to collection-based books.
Every healthcare engagement follows the same four-phase rhythm — built so your books are accurate before anyone tries to advise on them.
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Phase 1
Discovery
A 30-minute call to map your providers, locations, billing and payment systems, and where the books are breaking. No pitch.
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Phase 2
Cleanup & setup
If needed, a cleanup to move from charges to collection-based revenue, plus QuickBooks setup with provider and location structure.
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Phase 3
Monthly reconciliation
Payer deposits and accounts reconciled monthly, with per-provider performance, payroll, and patient refunds maintained.
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Phase 4
Reporting & advisory
A monthly package with per-provider and per-location margin, plus advisory as the practice grows.
Beyond the books
Clean books are the start. A stronger practice is the point.
Once payer deposits reconcile and your collection-based numbers are real, the question changes from “are the books right?” to “what do we do about them?” Which providers and service lines to grow, how the payer mix is shaping margin, when to add a location or staff, how to structure compensation — the decisions that actually build a practice.
That’s where healthcare advisory comes in: a Certified ProAdvisor who knows your numbers turning them into provider, payer-mix, and growth decisions. As automation commoditizes basic bookkeeping, this judgment layer is where the value — and the margin — now lives.
FAQ
Healthcare accounting questions.
Practices rarely collect what they bill. Gross charges, insurance contractual adjustments, write-offs, patient responsibility, and actual payer deposits are all different numbers, and revenue is only real once collected. Add per-provider and per-location performance, clinical payroll, patient credit balances that must be refunded, and the need to keep protected health information out of the books, and standard bookkeeping falls short.
Yes. We reconcile payer deposits to your QuickBooks file using remittance and deposit summaries, separating gross charges, contractual adjustments and write-offs, patient payments, and net collections, so you can see billed versus collected instead of one lump deposit. We work from financial summaries and do not require protected health information.
Yes. We configure QuickBooks so income and expense are tracked by provider and by location, typically using Classes or location tracking, giving you a real per-provider and per-location profit and loss alongside a consolidated view of the practice.
We integrate payroll for clinical and administrative staff, support provider-compensation tracking, and book patient credit balances as liabilities so overpayments are refunded rather than absorbed. TechBrot does not file income taxes and does not provide medical billing, coding, or legal compliance services — we coordinate with your CPA, billing company, and counsel as needed.
Accounting does not require protected health information. We work from financial summaries such as deposit reports and remittance totals, and keep PHI out of the books. We are not a medical billing or coding company and do not certify HIPAA compliance — your practice and its counsel retain that responsibility.
Pricing depends on the number of providers and locations, payer and payroll complexity, and reporting needs. Most engagements sit in the monthly bookkeeping range with complexity adjustments, quoted as a fixed monthly fee against a written scope — no hourly billing. See pricing.
Both. Accurate, collection-based books come first; then a Certified ProAdvisor can turn them into decisions — provider and service-line profitability, payer-mix analysis, staffing against revenue, cash-flow planning — through fractional CFO advisory. As automation handles routine data entry, this advisory layer is where the real value sits.
Page review & standards
Reviewed by the ProAdvisor team.
This page reflects how TechBrot actually handles healthcare engagements. It is maintained by the Certified QuickBooks ProAdvisor team at TechBrot Inc., a Delaware-incorporated independent ProAdvisor firm, and reviewed for technical accuracy on payer-deposit reconciliation, collection-based revenue, and per-provider tracking.
Where our approach or scope changes, this page is updated. We hold engagements to the standards described here. We are not a medical billing or coding company and do not certify HIPAA compliance.
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Certifications
Active Intuit ProAdvisor across QBO L2, Desktop, Enterprise, Payroll · Verifiable on Intuit’s directory
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Scope
Payer reconciliation, collection-based revenue, per-provider books, payroll, refunds · income-tax filing coordinated with your CPA/EA
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Engagement
Fixed-fee, written scope before work · delivered in your own QuickBooks file · built from financial summaries, not PHI
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Independence
Not affiliated with Intuit Inc. · QuickBooks is a registered trademark of Intuit Inc.
Page last reviewed: .
Ready when you are
Get practice books that match what you collect.
Book a 30-minute discovery call. We’ll review your providers, payer mix, where the books are breaking, and the right next step — with a written fixed-fee scope within 3 business days. No pitch.
TechBrot Inc. is an independent Certified QuickBooks ProAdvisor firm. QuickBooks is a registered trademark of Intuit Inc. TechBrot Inc. is not affiliated with Intuit Inc. TechBrot is not a medical billing or coding company and does not provide HIPAA compliance certification.