Healthcare Practices (Medical, Dental, Chiropractic)

Practice Financial Management: Revenue Cycle Reconciliation, Payer Mix Analysis, and Provider Compensation

Healthcare practices operate under a highly regulated, high-volume transactional model where cash flow is complicated by insurance contracts, deductibles, and complex billing codes. Standard bookkeeping often fails to accurately match payments to services rendered, leading to revenue leakage.

At 23 Forever Bookkeeping LLC, we specialize in financial systems designed to simplify the revenue cycle, provide clear data on profitability per provider, and support compliance.

Our Expertise Addresses Key Practice Management Challenges:

1. Revenue Cycle Reconciliation & Payment Tracking

This is the most critical area for any practice's cash flow. We ensure the revenue recorded in your books accurately reflects the collections from patients and payers.

• Payer Mix Analysis: We structure your reporting to clearly identify revenue streams from Medicare, commercial insurance, and patient self-pay. This data is vital for strategic decision-making and contract negotiation.

• Payment-to-Service Match: Reconciling bank deposits to the complex Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA) documents from clearinghouses, ensuring payments are correctly categorized and linked to billed services.

• A/R Management: Tracking and reporting on overdue claims and patient balances so you can take prompt action, reducing revenue leakage.

2. Provider Compensation & Expense Allocation

For multi-provider practices (e.g., group dental offices or chiropractic clinics), accurate expense allocation and compensation calculation are essential for fairness and retention.

• Expense Allocation: Accurately allocating shared practice overhead expenses (rent, utilities, administrative payroll) across individual providers or profit centers for true profitability analysis.

• Compensation Data: Providing clean, timely data used to calculate provider commissions or bonuses based on production, collections, or service volume.

3. Compliance and Regulatory Support

We provide the back-office structure necessary to support the high standards of the healthcare industry.

• Payroll Complexity: Handling specialized payroll needs, including tracking licensed staff (DDS, MD, DC, RNs) wages, benefits, and required withholdings.

• HIPAA Data Security: While we do not handle Protected Health Information (PHI), we ensure our financial systems and data storage protocols comply with the security best practices required when interacting with healthcare financial data.

Our goal is to transform your complex revenue cycle into a predictable financial flow, giving providers and practice managers the confidence to focus entirely on patient care and growth.

Assisted Living & Senior Care Financial Management

Managing the finances for an Assisted Living Home requires meticulous attention, especially concerning compliance and the ethical handling of resident funds. At 23 Forever Bookkeeping LLC, we specialize in financial systems designed to meet the rigorous demands of this industry, protecting both the facility and its residents.

Our Expertise Addresses Key Facility Challenges:

1. Resident Trust Account Oversight (Fiduciary Responsibility)

This is a critical area that requires zero error. We provide dedicated support to manage funds held on behalf of residents.

• Segregation & Compliance: Ensuring funds are properly segregated from operating accounts and managed in strict adherence to state and federal regulations.

• Detailed Transaction Tracking: Meticulously tracking all deposits and disbursements for personal expenses (e.g., salon, outings, clothes) and generating clear, accurate monthly statements for residents and their families.

• Audit Readiness: Maintaining the precise documentation needed to pass compliance reviews and audits related to these fiduciary accounts.

2. Specialized Payroll & Staffing

We understand the complexity of managing payroll for a rotating staff of caregivers, nurses, and support personnel.

• Shift & Differential Pay: Handling complex scheduling, shift differentials, and overtime requirements common in 24/7 care facilities.

• Compliance & Tax Filings: Ensuring all payroll tax filings and required wage reporting comply with industry standards and state labor laws.

3. Revenue & Expense Management

We structure your core operating books to provide clear insight into the facility's financial health.

• Billing Integration: Streamlining the recording of resident service revenue, whether paid privately, through Medicaid/Medicare, or other funding sources.

• Cost Management: Accurate tracking of supplies, food service costs, utilities, and maintenance to help identify areas for efficiency and cost reduction.

Our goal is to ensure your financial reporting is accurate, your compliance obligations are met, and administrators can focus solely on providing exceptional care.

Nonprofits and Mission-Driven Organizations

Nonprofit Fund Accounting, Compliance, and Audit Support

Managing the finances of a nonprofit organization is fundamentally different from managing a for-profit business. It requires adherence to specific guidelines, meticulous tracking of donor restrictions, and specialized reporting to maintain tax-exempt status.

At 23 Forever Bookkeeping LLC, we specialize in providing the clear, compliant financial structure needed to keep your focus on your mission.

Our Expertise Addresses Key Nonprofit Requirements:

1. Fund Accounting & Donor Restriction Tracking

We move beyond simple accrual accounting to implement and manage true Fund Accounting systems, which is the cornerstone of nonprofit finance.

• Restricted vs. Unrestricted Funds: Accurately tracking and reporting funds based on donor-imposed restrictions (e.g., specific grants or programs).

• Segregation & Reporting: Ensuring financial statements clearly distinguish between permanently restricted, temporarily restricted, and unrestricted net assets, providing necessary visibility to your board and stakeholders.

• Grant Management: Setting up systems to track spending against specific grant budgets to ensure compliance and simplify reporting to grantors.

2. Form 990 Preparation & Audit Support

Your annual Form 990 is a public disclosure and a critical compliance document. We ensure your data is clean and ready for your tax preparer.

• 990 Readiness: Structuring your General Ledger throughout the year to capture required expense categories, making the final preparation of the Form 990 efficient and cost-effective for your CPA.

• Audit Documentation: Organizing and maintaining documentation for all programs, functional expenses, and donor contributions, ensuring you are audit-ready at all times.

3. Functional Expense Reporting

We help you categorize every expense properly across the three functional areas required for transparency:

• Program Services (the direct cost of fulfilling your mission).

• Management & General (administrative and overhead costs).

• Fundraising (costs associated with generating donations).

Our goal is to give your board, donors, and grantors complete confidence in your financial stability and ethical stewardship, allowing you to maximize your impact.

Service Businesses and Contractors

Job Costing, Fixed Assets, and Profitability for Service Trades

Businesses in the service trades—from plumbing and HVAC to automotive repair and general contracting—thrive or fail based on the accuracy of their bids and their ability to control project costs. General bookkeeping often fails to provide the granular data necessary for true profitability analysis.

At 23 Forever Bookkeeping LLC, we set up specialized systems that ensure you know exactly how much you profit on every job, allowing you to price services correctly and grow strategically.

Our Expertise Addresses Key Contractor Needs:

1. Job Costing & Project Profitability

Job costing is the most critical tool for contractors. We set up your QuickBooks Online file to track costs and revenue per job, not just company-wide.

• Accurate Data Capture: Meticulously tracking all expenses, including direct labor, materials, subcontractor costs, and overhead allocation, directly to the associated job or service ticket.

• Real-Time Profitability: Providing you with Job Profitability Reports so you can compare budgeted costs versus actual costs before the job is complete, preventing loss and informing future bids.

• Informed Bidding: Giving you the historical data needed to confidently increase prices on jobs that were under-bid and accurately replicate success on the most profitable service types.

2. Fixed Asset Management & Depreciation

Your equipment—from specialized tools and trucks to machinery—is a significant investment that impacts your balance sheet and tax liability.

• Asset Tracking: Setting up a clear register to track every high-value asset, including purchase date, cost, and serial numbers.

• Depreciation Schedules: Working with your CPA to ensure timely and accurate recording of depreciation, optimizing tax deductions and providing a true picture of your company’s value.

• Lifecycle Management: Tracking repairs and upgrades to help inform decisions on when to repair equipment versus when to replace it.

3. Inventory and Materials Tracking

For trades that stock parts (like automotive or plumbing), we manage the financial side of your inventory to prevent stockouts and tie materials directly to jobs.

• Cost of Goods Sold (COGS): Ensuring materials are moved from inventory to COGS only when sold or used on a job, providing a true picture of your gross margin.

• Sales Tax Compliance: Managing sales tax collection and filing related to taxable materials and services in your various service areas.

Our goal is to turn your accounting system into an essential management tool that drives intelligent bidding, maximizes project margins, and ensures your equipment investments are properly valued.tem description