Medical Practice Tax/Accounting

The demand of the marketplace is causing ongoing changes in the medical industry. These changes may cause old beliefs about how medicine should be practiced to become obsolete. Physicians must therefore pay attention to the business aspects of a medical practice.

Numbers are data. What any physician needs from his or her CPA is information. In many clinical situations, the numbers are information. In business situations, most numbers are data – the value a physician CPA brings to the medical practice is applying his or her knowledge, experience and judgment to turn data into information, information that is the basis for decision making.

My accounting services are divided in to two categories – nontraditional and traditional:

Nontraditional Accounting Services

Finance Review Diagnostic business planning begins with the evaluation of the overall finances of the medical practice. Particular emphasis should be placed on charges, collections, adjustments, and other write offs. Is the practice growing or are the doctors working harder to maintain the same income level?

Financial Percentages and Ratios Ongoing review of the practice’s gross collection percentage, net collection percentage, and accounts receivable ratio or days in A/R. Assess whether all these statistics are reasonable for the practice’s particular medical specialty.

Overhead Review Compare each overhead category to the same overhead category from the prior year. Identify and question significant changes. In addition, decide how the practice’s overall overhead can be reduced in the upcoming year.

Cost Accounting Every practice needs to know what it costs to render a particular service. These calculations should be prepared at least annually.

Accounts Receivable Conduct an in-depth analysis of a current aging of the accounts receivable, with emphasis on payer aging’s.

Managed care accounting Review all managed care plans to assess their profitability. If the plan’s rates or profitability are not acceptable, assess the potential for renegotiation.

Traditional Accounting Services

Compilation A compilation of financial statements is defined as presenting in the form of financial statements information that is the representation of management (owners) without undertaking to express any assurance on the statements.

Independent Review of Internally Prepared Financials For physician practices who prepare their own financial statements internally, it is often a good idea to have them independently reviewed by a CPA. This review can be conducted on a monthly, quarterly, semi-annual, or annual basis. You must make sure they are receiving accurate, reliable financial information.

Financial Forecasts and Projections A physician practice might want or need to prepare a financial forecast for many reasons: [a] to budget income and expenses for the upcoming year, [b] for general business planning purposes, [c] to aid in the valuation of the entity, or [d] to fulfill a lender’s requirement for granting a loan. The difference between a forecast and a projection is that in a forecast, all the assumptions are expected to occur, whereas in a projection at least one assumption is not necessarily expected to occur and may be improbable. In other words, a forecast presents management’s expectations; a projection presents management’s expectations based on a ‘what if’ situation.

Personal Financial Statements There may be a time when a physician needs to have a prepared personal financial statement. Personal financial statements are sometimes needed when obtaining a bank loan, for tax or estate planning, or during the preparation of a personal financial plan.

As a CPA dedicated to physicians and their medical practices, my goal is to minimize your tax burden and make sure there are no year-end tax surprises. My tax services include the following:

  • Tax planning and analysis
  • Tax projections and analysis
  • Tax preparation Federal and State
  • Representation before taxing authorities
  • Problem resolution
  • Practice acquisition/divestiture tax consulting
  • Structuring of physician buy-ins and buy-outs
  • Tax impact of proposed practice merger
  • Practice valuation tax analysis