The Problem We Solve

Why healthcare businesses need accounting built for them.

Healthcare accounting is dominated by insurance billing reconciliation: what was billed vs. allowed vs. paid vs. patient-responsibility, with timing differences that span months. Generalist firms book gross billings as revenue and create financials that overstate income. Add HSA/FSA tracking, equipment financing schedules, physician compensation structures, and multi-entity arrangements (MSO/PC structures) and the practice quickly outgrows commodity accounting.

Scoped to Healthcare

What we deliver for healthcare clients.

Every engagement combines our core accounting practice with the industry-specific knowledge healthcare businesses need.

Healthcare Bookkeeping

Practice bookkeeping with proper revenue accounting from billed to collected.

Tax Preparation

Federal and state returns for the practice entity and physician owners.

Tax Planning

Year-round planning including equipment timing, retirement contributions, and entity structure.

Payroll

Multi-state payroll with provider-level allocation for cost analysis.

Fractional CFO

Per-provider profitability, location-level reporting, and acquisition or sale support.

IRS Resolution

Representation for healthcare-practice audits including physician compensation challenges.

Why Trust Troy Accounting

Practice depth, documented standards, accountable people.

We hold ourselves to documented editorial standards, a published client success methodology, and the compliance posture appropriate to a U.S. professional accounting firm. Specifically for healthcare engagements:

  • Insurance billing reconciliation: billed to allowed to paid to write-off accounting
  • Practice management system integration: Athena, Epic, eClinicalWorks, Dentrix, Open Dental
  • Physician and partner compensation structures including productivity-based formulas
  • MSO/PC structures for non-physician ownership-restricted states
  • Equipment financing schedules and Section 179 / bonus depreciation planning
  • HSA, FSA, and retirement plan accounting
  • Multi-location consolidated reporting and per-location P&L

We are not a CPA firm. For engagements requiring CPA attestation, we coordinate with our licensed CPA partner network. We do not exaggerate credentials, and the named team on your engagement is the team that performs the work.

Common Questions

FAQ for healthcare clients

Can you reconcile from my practice-management system?

Yes. We integrate with Athena, Epic, eClinicalWorks, Dentrix, Open Dental, Eaglesoft, and others. We reconcile from PM-system reports rather than from gross deposits.

Do you handle MSO/PC structures?

Yes. We handle the bookkeeping, tax, and reporting for management services organizations and the affiliated professional corporations or PLLCs in states that require physician ownership.

What about ASC structures?

We work with ambulatory surgery centers including the physician-investor distribution accounting and the related-party transaction documentation.

Can you help with a practice acquisition?

We support the buyer's diligence, quality-of-earnings work, and post-close transition accounting. For valuation or transaction structuring beyond accounting matters, we coordinate with M&A advisors.

What Happens Next

Three steps from here to a working engagement.

01

Generate a quote

Eight questions, 90 seconds, a locked final monthly price scaled to your specific healthcare profile.

02

Discovery call

A 20-minute call to confirm the scope, meet your account lead, and align on the engagement details.

03

Onboard in 2 to 6 weeks

We rebuild your books to a clean baseline and run our first monthly close in parallel before fully taking over.

Schedule Consultation Request Proposal Call