#healthcare
Financial management and accounting solutions for healthcare businesses
Employer HSA contributions outside a Section 125 cafeteria plan must be identical across comparable employees, or the IRS imposes a 35% excise tax on the full contribution pool, not just the excess.
Utah, Tennessee, Alabama, Georgia, and West Virginia have passed portable benefits laws letting businesses fund contractor health, retirement, or PTO accounts without that contribution counting as evidence of misclassification under state law — but the safe harbor is state-only and doesn't touch federal IRS or DOL tests.
Urgent care clinics typically target 28-35 days in accounts receivable, an 8-15% denial rate, and a 95%+ clean claim rate, while losing 15-25% of ancillary revenue to uncaptured charges — tracking these by payer category is what catches billing problems before they become a cash crunch.
Pharmaceuticals and supplies run 20-25% of revenue at a typical small-animal practice, and the AAHA/VMG chart of accounts plus DEA-compliant drug logs are what keep that margin from quietly leaking away.
OBBBA Section 71308 and IRS Notice 2026-05 let you pair a Direct Primary Care membership of up to $150/month per adult ($300 family) with an HSA starting January 2026, reclassify all Bronze and Catastrophic marketplace plans as HSA-eligible, and make the telehealth pre-deductible safe harbor permanent. Here is how freelancers, solo S-corp owners, and small employers should stack DPC, marketplace coverage, HSAs, and QSEHRA/ICHRA reimbursements without double-dipping.
The enhanced premium tax credits expired January 1, 2026, restoring the 400% FPL cliff. This guide walks self-employed filers, S-corp owners, freelancers, and early retirees through the 2026 applicable percentage schedule, MAGI levers like Solo 401(k), SEP-IRA, HSA, and Section 162(l), and Form 8962 reconciliation strategies to avoid five-figure repayments.
How independent and DSO-affiliated dental practices should record production, PPO contractual write-offs, management fees, and operatory depreciation under ASC 606 — plus the KPIs (collection ratio, overhead %, hygiene production ratio) that separate a 60% overhead office from a 75% one.
How solo and multi-therapist massage practices account for prepaid memberships and gift certificates under ASC 606, navigate W-2 vs 1099 classification under the 2024 DOL rule and state ABC tests, capitalize treatment rooms under Section 179, claim the Section 45B FICA tip credit, and track revenue per table-hour against AMTA benchmarks.
What the Pregnant Workers Fairness Act requires under 29 CFR Part 1636, how the PUMP Act layers on top under FLSA Section 7(r), what the 2025 federal court rulings actually vacated, and the six-step interactive process records small and mid-size employers need to defend an EEOC charge in 2026.
How to set up the chart of accounts, ASC 606 deferred revenue, MSO structure for IV drip, Section 179 and QIP cost segregation, and the four KPIs (RevPATH, visits per member-month, LTV, modality contribution margin) that predict EBITDA in a recovery wellness studio.
How independent doulas should structure their books — allocating prepaid birth packages across performance obligations, classifying backup doulas correctly, handling HSA/FSA and Medicaid payment pathways, and reading the KPIs that predict whether a perinatal practice is actually sustainable.
A practical bookkeeping guide for solo and group mental health private practices — covering contractual allowances under ASC 606, No Surprises Act Good Faith Estimates, PSYPACT and Counseling Compact licensure, 1099-versus-W-2 classification under the 2024 DOL rule, S-corp reasonable compensation thresholds, and the six monthly KPIs (utilization, no-show rate, net collection rate, days in A/R) that determine whether a counseling practice stays solvent.
