Industries · Medical Practices
Accounting & Tax for Medical Practices
You did not spend a decade training in medicine to spend your evenings decoding payer remittances.
South Florida's medical corridor runs deep, independent physician practices, multi-provider groups, and specialty clinics from Aventura to Kendall serve one of the country's largest and fastest-aging patient populations. Yet the economics of practicing medicine here get harder every year: reimbursement rates compress, payer rules multiply, and the administrative load falls on physicians who would rather be seeing patients than reconciling remittance advices.
Medical practice finance has a rhythm all its own. Revenue arrives thirty to ninety days after the visit, filtered through payer contracts, denials, and patient responsibility balances, so the bank account never matches the appointment book. Provider compensation formulas, productivity-based, collections-based, or salaried with bonuses, demand clean data to stay fair and defensible. Equipment and buildout investments carry major depreciation implications, and physician household income levels make personal tax planning inseparable from the practice's books.
Integris Accounting serves practices as a true outside finance department. We reconcile deposits to your practice management system, report collections and overhead by provider, plan taxes across the entity and the physicians together, and run payroll for clinical and front-office staff. With Edgar Gomez's advanced tax credentials and Big Four background, high-income planning is handled at the level your situation actually requires.
The landscape
60,000+
licensed physicians practicing across Florida
30-90
days from date of service to insurance payment on a typical cycle
10%+
of claims initially denied at many practices
Core services for medical practices
The challenges
What makes medical practices accounting hard
Cash that lags the schedule by months
A full appointment book means little when payers remit in sixty days and deny a share of claims outright. Practices without payer-cycle cash planning run tight on payroll in months their production was excellent.
Provider compensation disputes
Productivity and collections-based comp formulas breed conflict when the underlying data is messy. Providers who doubt the numbers doubt the partnership, and recruiting suffers when the model cannot be explained cleanly.
Overhead creeping past benchmarks
Staffing, rent, malpractice premiums, and software subscriptions drift upward while reimbursements stay flat. Without overhead-ratio tracking against specialty benchmarks, the squeeze on physician income goes undiagnosed.
High-income tax exposure left unplanned
Physician earnings invite the top brackets, phase-outs, and additional Medicare taxes. Practices that only see their CPA at filing time forfeit retirement plan design, entity strategy, and timing opportunities worth real money.
Our approach
How we help
Payer-cycle cash management
Deposits reconciled to your practice management system, receivables tracked by payer aging, and a cash forecast built around actual reimbursement lags, so payroll never depends on which insurer paid this week.
Provider-level financial reporting
Collections, direct costs, and allocated overhead reported by provider monthly, giving compensation formulas a clean, trusted data foundation and partners a fair view of contribution.
Overhead benchmarking and control
Your expense structure measured against specialty norms, with staffing ratios, occupancy, and vendor contracts reviewed regularly so margin erosion is caught early and addressed deliberately.
Integrated practice and personal tax strategy
Entity structure, retirement plan design, equipment depreciation timing, and household-level planning coordinated in one place, because a physician's practice return and personal return are one financial system.
Clinical payroll and compliance
Payroll through ADP for providers and staff, handling productivity bonuses, benefits, and retirement contributions correctly, with clean records for the practice's many regulatory and credentialing touchpoints.
FAQ
Medical Practices accounting, common questions
What overhead percentage is normal for a medical practice?
It varies widely by specialty, primary care commonly runs near 60 percent of collections, while some procedural specialties run leaner and others heavier. The absolute number matters less than your trend and your gap versus specialty benchmarks. We track your overhead ratio monthly, decompose it into staffing, occupancy, and supplies, and flag the drivers when it drifts, so corrections happen in weeks rather than years.
Should my practice be a PLLC, PA, or S corporation for tax purposes?
In Florida, physicians typically organize as a PLLC or PA, and the meaningful tax question is whether that entity elects S corporation treatment, which can reduce self-employment tax exposure when structured with a reasonable salary. The right answer depends on income level, number of owners, benefit plans, and exit plans. We model the alternatives with your actual figures and coordinate the election paperwork end to end.
How can a high-earning physician meaningfully reduce taxes?
The durable levers are structural: maximizing qualified retirement plans, often a 401(k) paired with a cash balance plan for larger deferrals, optimizing entity structure and compensation mix, timing equipment and buildout depreciation, and coordinating household investments and charitable strategy. One-off tricks rarely survive scrutiny; a coordinated annual plan does. We build that plan and revisit it every quarter, not every April.
Can you work alongside my billing company or in-house biller?
Yes, and the practice runs better when we do. Your biller manages claims and collections; we reconcile what actually lands in the bank against what the practice management system says was collected, catching posting errors, missing deposits, and payer underpayments. That reconciliation is precisely the control most practices lack, and it turns billing reports into numbers you can actually trust.
Where we serve medical practices
Talk to a CPA who knows medical practices
Let your practice run on numbers as precise as your clinical work, call (305) 497-0552.