What Is An Accountant For Healthcare Industry In USA

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Healthcare Accounting

Healthcare enterprises derive income from insurance payments, patients, and grants, amongst other sources. The enterprises pay for supplies, wages, and overheads. However, income and expenses are rarely synchronized. Insurance companies and patients often delay payments. Enterprises source regular and infrequent supplies from multiple vendors who require payment. Also, healthcare accounts must always comply with strict HIPAA requirements. Healthcare accounting is a balancing act requiring trained accountants specializing in healthcare accounting. 

  1. The law and politicians who regulate healthcare are aware of its importance; hence healthcare is prone to rapid changes. Only soundly managed hospitals or healthcare services can survive the ever-changing industry.
  2. The industry is prone to fees, fines, and even criminal charges when mismanaging accounts.

Typical Consumers of Healthcare Accounting

  1. Assisted Living Facilities
  2. Dental Practitioners
  3. Diagnostic Clinics
  4. Hospitals
  5. Laboratories
  6. Medical Clinics
  7. Nursing homes
  8. Orthodontic Practitioners
  9. Outpatient Facilities
  10. Specialist Practices

Stakeholders Dependent on Healthcare Accounting Reports and Controls

  1. Care Facilities.
  2. Employees.
  3. Employers.
  4. Federal and State Government.
  5. Healthcare Providers.
  6. Insurance Companies.
  7. Legislators.
  8. Patients.
  9. Pharmaceutical companies and medical device manufacturers.

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Healthcare Accountants

Healthcare accountants work for hospitals, insurance companies, and medical practices. One of their primary responsibilities is to oversee compliance with federal, state, and local laws and regulations imposed on healthcare management and accounting. However, the most critical task healthcare accountants face is Revenue Cycle Management. 

Revenue Cycle Management

Looking after revenue generation, payments, and claims of a medical office is of self-evident importance.   The cycle includes computer-based billing and tracking of medical claims by patients. The process includes:

  1. Co-payment collections.
  2. Management of claims denied.
  3. Medical diagnostic code accuracy.
  4. Patient eligibility determination.
  5. Payment Collections.
  6. Tracking of claims.

Daily tasks include:

  • Allocation of revenue.
  • Budget development.
  • Calculation of depreciation.
  • Control of the balance sheets.
  • Determination of income and expenses.
  • Monitoring financial reporting.
  • Producing accounting reports.
  • Tracking reimbursements.

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What is Medical Centers Bookkeeping?

Bookkeeping is the keeping of the books for healthcare so in this sense for example it starts with the bank accounts, the healthcare companies open a bank account and receive the payments from agencies. There are agencies for all those who care retirees at home, they are in the middle companies that they deal with Medicare, and they subcontracted this companies, they will receive their income from this middle agency that deal directly with Medicare and many of these small providers of services do not directly deal with Medicare. All that will be handled by an intermediary, and they will deal with the providers of each service, and this is how they receive income, when that happens then the accounting, the bookkeeping is straightforward, the income is the money received from the intermediary or Medicare directly. And all expenses are paid to third parties.

What are The Benefits of Having A CPA Specialized in Medical Centers?

The benefit will be the understanding of the industry from the CPA and how that knowledge will help the owner of the company to correctly classify the expenses and the elaboration of the tax return in the year and the decisions that the owner must take during the year for the administration of the business. Just to give an example, what will be easier dealing with Medicare directly or dealing with an intermediary, Medicare will always require more. So, if the owner doesn’t have the required licenses Medicare will not be able to provide for service and perhaps will be easier to deal with a provider in the middle because it depends on the ability of the vendor to have the capital to deal directly with Medicare and at the end of the year the correct classification of the expense for the elaboration of the tax return.

Readers should note that this article is only intended to convey general information on these issues and that FAS CPA & Consultants (FAS) in no way intends for the contents of this article to be construed as accounting, business, financial, investment, legal, tax, or other professional advice or services.  This article cannot serve as a substitute for such professional services or advice.  Any decision or action that may affect the reader’s business should not rely solely on the contents of this article but should rather be consulted on with a qualified professional adviser. FAS shall not be responsible for any loss sustained by any person who relies on this presentation.  This article is subject to change at any time and for any reason.

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