63% ▲ 5.0 pts since April
For medical practices
Run the practice on numbers you can trust.
We run your finance function. You get strategic insights. For privately owned US medical practices, a dedicated team runs bookkeeping, payroll, accounts payable, and accounts receivable with Delphi AI under their oversight. Once a month, Visory Insights shows the practice owner what changed, what it means, and what to do next.
- Every payer deposit matched to its remittance, from insurers, Medicare, and patients, so collections are clear by payer before anyone is paid.
- Every pay run owned by a named Payroll Specialist, checked by Delphi AI before it is paid, from overtime for front desk and clinical staff to pay for employed physicians.
- The practice’s own result every month, collections against staff, rent, and supplies, briefed by your Business Performance Partner with one move to make.
Who this is for
Built for practices where the owner also runs the business.
If your month runs on appointment books, payer deposits, and a front desk that has to be paid correctly, this is the finance function for it.
- Physician practices, specialty groups, dental practices, and physical therapy clinics, and the multispecialty practices that combine them.
- Privately owned and run for profit, roughly $750k to $20m in revenue, led by a practice owner or managing physician who carries the result.
- Physicians and clinicians who are employed, contracted, or both, with collections from insurers, Medicare, Medicaid, and patients.
- Front desk, medical assistants, and administration staff paid hourly, with overtime when clinics run late.
Anywhere in the United States. Your books stay in your own QuickBooks or Xero file, which you own, and your dedicated team works inside it.
The pressure
Four federal rules sit under every physician payment and pay run.
A practice pays some physicians as employees and others as contractors, pays its staff by the hour, and is paid by payers who each send money and paperwork their own way. Federal tax law, wage law, and the HIPAA transaction standards each read those same payments their own way. The books are where that is kept straight, or missed.
The contracted physician who works like staff is the one to watch.
A physician on a fixed weekly schedule, using your rooms, staff, and systems, is a different case from a locum booked for a month. The books show who you pay, how, and for how long.
Set by IRS common-law rules; Fair Labor Standards Act
For federal employment taxes, the IRS looks at behavioral control, financial control, and the type of relationship, and you may be liable for employment taxes on a worker you treated as a contractor without a reasonable basis. Under the Fair Labor Standards Act, the test is economic reality: whether the worker depends on your business for work or is in business for themself. A physician’s title, a contract, or a professional corporation does not settle the question on its own.
Internal Revenue Service, Independent contractor (self-employed) or employee?, page reviewed May 19, 2026; 29 CFR part 795, effective March 11, 2024; Wage and Hour Division, Field Assistance Bulletin 2025-1, May 1, 2025.Sources IRS: contractor or employee DOL: Field Assistance Bulletin 2025-1
A physician’s professional corporation still gets a form.
Contracted physicians are paid against a W-9 and coded to the person or corporation you contracted with, so each year-end total is in the ledger when the forms are due.
Set by Forms 1099-NEC and 1099-MISC; Public Law 119-21
For tax years beginning after 2025, a business reports nonemployee compensation of $2,000 or more on Form 1099-NEC, due to the recipient and the IRS by January 31. It also reports, in box 6 of Form 1099-MISC, payments of $2,000 or more made in the course of its business to each physician or other provider of medical or health care services. The usual exemption for payments to corporations does not apply to medical or health care services, including professional corporations. Form 1099-MISC goes to the recipient by January 31 and to the IRS by February 28 on paper or March 31 electronically.
Internal Revenue Service, Instructions for Forms 1099-MISC and 1099-NEC (Rev. December 2026): Filing dates, Box 1a (Nonemployee compensation), Box 6 (Medical and health care payments), and the $2,000 threshold for tax years beginning after 2025 under Public Law 119-21; Internal Revenue Code section 6071(c).Late clinics show up in the pay run.
A medical assistant who stays past 40 hours is paid overtime in that week, so every run is checked against the timesheets before it is paid, while employed physicians are paid as their contracts set.
Set by Fair Labor Standards Act; 29 CFR 541.304
Unless exempt, an employee covered by the Fair Labor Standards Act is paid at least time and one-half for hours over 40 in a workweek. An employee who holds a valid license to practice medicine and actually practices it is exempt as a professional, and the salary requirements that apply to other exempt employees do not apply. The exemption names medical doctors, osteopathic physicians, podiatrists, dentists, and optometrists, and covers residents and interns.
Fair Labor Standards Act, section 7(a); 29 CFR 541.304 (practice of law or medicine), paragraphs (a) to (d); eCFR current to October 7, 2026.One deposit can pay for hundreds of visits.
Each payer deposit is matched to its remittance by the trace number, so collections are recorded by payer and the gap between what was billed and what was paid is visible each month.
Set by HIPAA administrative simplification; 45 CFR 162.1602
A health plan that pays a provider electronically uses the NACHA CCD+ format, with the reassociation trace number from the X12 835 health care claim payment and remittance advice in its addenda record, and sends the remittance advice itself in the X12 835 standard. The adopted operating rules include an EFT and ERA reassociation rule, so the deposit in the bank and the remittance that explains it can be matched.
45 CFR 162.1601, 162.1602(d), and 162.1603(a), standards in effect on and after January 1, 2014, as amended by 77 FR 1590, January 10, 2012, and 77 FR 48043, August 10, 2012; eCFR current to October 7, 2026.Every instrument named here is listed with its effective date at the foot of this page.
Would your payer deposits and your books tell the same story? Start with a discovery call. A senior member of the Visory team then runs the free financial health check on your own numbers, before anything is agreed.
Book a discovery callWhat we run for medical practices
From accurate processing to leadership confidence.
Visory Insights leads. The basics underneath it make it trustworthy and free your team for the work that matters, run by a dedicated team with Delphi AI under their oversight.Flat monthly fee. No hourly billing.
- 1 Accurate processing Bookkeeping and payroll done right, every month.
- 2 Clean, reliable data The foundation that makes reporting defensible.
- 3 Meaningful insights Cash, margin, and the year ahead, explained.
- 4 Leadership confidence You present numbers you trust. The plan gets backed.
The leading service
Visory Insights
Collections by payer, staff cost, and overhead, explained once a month with one move to make. A named partner who reads the practice’s numbers with the owner and turns them into the next decision.
See how Visory Insights works- Monthly plain-English report
- Structured session with your leadership team
- Twelve-month forward view of cash
- A named Business Performance Partner
The basics underneath it
Bookkeeping
Insurer, Medicare, Medicaid, and patient payments reconciled to the bank and to their remittances by payer, so collections are clear before anyone is paid.
Explore bookkeepingPayroll
Pay runs for front desk, medical assistants, and employed physicians, with withholding and filings prepared from the same run.
See how payroll runsAccounts payable
Contracted physician payments, rent, medical supplies, lab fees, and software bills checked and paid when you approve them.
See accounts payableAccounts receivable
Invoices the practice issues outside claims, such as service contracts with employers and facilities, raised and followed up in your name.
See accounts receivableBilling, claims, and coding stay with your practice. Your team or billing company submits claims, posts charges, and works denials in your practice management system, and Visory reconciles what is paid. How physicians are paid, and whether an arrangement meets HIPAA, the physician self-referral law (the Stark Law), or the Anti-Kickback Statute, are matters for your practice and its counsel; Visory does not advise on them.
Visory Insights for medical practices
One month of Visory Insights, on a practice’s numbers.
Reports tell you what happened. Visory Insights tells you what it means, and what to do about it. Here is one month for Kestrel Park Health, a fictional physician and physical therapy practice collecting about $4.8m a year across 14 clinicians.
Collections are holding at about $400k a month. Overhead is not. Five points of overhead on $4.8m is $240k a year.
Staff cost, share of collections 31% At Risk 4 points past the 27% the practice planned: overtime and agency cover for two medical assistant roles open since June
Operating overhead, share of collections Filling the two roles and ending the agency cover returns three of the four points, about $144k a year
Fill the two open medical assistant roles, and end the agency cover and the standing overtime once they start. The overtime and agency cost by week and by clinic is prepared for your session.
≈ +$144k a year Insight session Accepted 9:00 to 9:45am · Video call 
With your Business Performance Partner
With your Business Performance Partner
Prepared and checked by Delphi AI, and briefed by your Business Performance Partner in a structured session, in plain English.
- Monthly plain-English report
- Structured insight sessions
- Collections by payer and overhead, every month
See this on your own numbers. A discovery call is a conversation about your physicians, your payer mix, and what you want each month to show you.
Book a discovery callFits your stack
Works with the tools you already use.
Your ledger and your payroll stay where they are. Visory connects to them and keeps the data flowing every day, so your team and Delphi are working from current numbers.
Accounting and books
Where your ledger and reporting live.
Payroll and people
Pay runs, payroll tax withholding and filings, and the people behind them.
Practice management, payers, and card terminals
Your practice management system keeps the schedule, the charges, and the claims. Payer deposits, patient card payments, and their remittances are matched to the ledger through your bank feeds, by payer and by clinic.
Resources for medical practices
Content written for medical practices by the expert teams at Visory.
Common questions
Straight answers for medical practices.
The questions practice owners ask before they hand Visory the finance function. The general ones are on the common questions page.
How do you account for contracted physicians?
As vendors, not staff. Each contracted physician, or their professional corporation, is set up with a W-9, paid through accounts payable on the terms of the agreement once you approve it, and coded to the person or corporation you contracted with. That keeps the year-end total for each one in the ledger. Whether a physician is an employee or a contractor is decided by the facts of the relationship, and that call is yours, with your advisors.
Do Medicare payments for a physician’s services belong to the practice?
Only through an employment or reassignment arrangement. Medicare generally pays the physician who furnished the service, but it may pay the employer when the physician must turn over fees as a condition of employment, or an enrolled entity that bills for the physician’s services under a contractual arrangement. In that case the entity and the physician are jointly and severally responsible for any overpayment (42 CFR 424.80). Visory records each payment against the payer and clinician it belongs to; enrollment and reassignment stay with your practice.
Which form do we file for a contracted physician?
It depends on the payment. Nonemployee compensation of $2,000 or more goes on Form 1099-NEC, due by January 31, and payments of $2,000 or more to a physician or other provider of medical or health care services are reported in box 6 of Form 1099-MISC. Unlike most payments, payments for medical or health care services are reported even when made to a corporation, including a professional corporation. Visory keeps each physician’s payments coded so the totals are ready; which box applies is a question for your tax advisor. This is general information, not tax advice.
Why do insurers send our practice a Form 1099-MISC?
Because they must. A payer reports payments of $2,000 or more to each physician or other provider of medical or health care services in box 6 of Form 1099-MISC, including payments made by medical and health care insurers, and lists the corporation as the recipient when it pays one. Visory reconciles each insurer’s deposits by payer through the year, so the forms that arrive in January can be checked against the ledger.
Are our medical assistants and front desk staff owed overtime?
Generally, yes. Under the Fair Labor Standards Act, an employee who is not exempt is paid at least time and one-half for hours over 40 in a workweek, and most hourly practice staff are not exempt. Licensed physicians who practice medicine are exempt as professionals, with no salary requirement. A Payroll Specialist runs every pay cycle against your timesheets, with Delphi AI checking each variation before you approve the run. This is general information, not legal advice.
Can you pay our physicians each month?
Yes. Employed physicians are paid through payroll as their contracts set, and contracted physicians through accounts payable. Delphi AI prepares each payment from the reconciled ledger and the agreement’s terms, your Visory team oversees it, and you approve the payment before it is made. How compensation is set, and whether it meets the physician self-referral law or the Anti-Kickback Statute, is for your practice and its counsel.
How do you reconcile insurer, Medicare, and card payments?
Through your bank feeds, against the remittances and payment reports from your practice management system. Electronic payer deposits carry a trace number that ties each deposit to its remittance advice, and card terminals settle on their own cycles. Each deposit is matched to the remittance behind it, by payer, so unmatched deposits and short payments surface while your billing team can still act on them.
Do you submit claims or run our billing?
No. Billing, coding, claims, and denials stay with your practice, your billing company, and your practice management system. Visory reconciles what is paid, keeps the ledger behind it, and raises the practice’s own invoices outside claims.
How much does Visory cost for a practice?
Visory charges one flat monthly fee for the scope we agree. No timesheets, no hourly billing, no surprises. The fee reflects the services you take and the volume of work in the practice, from the number of clinicians and pay runs to the payments reconciled each week, so you know the monthly cost before you start.
See how pricing works More questions, longer answers. Every question has its own link. See all common questions
General information for medical practices, not financial or tax advice.
Getting started
Start with clarity, not a contract.
Three steps, in whatever rhythm suits you. Each one is useful on its own.
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Book a discovery call
An obligation-free conversation about your physicians, your payer mix, and what you want the numbers to tell you.
Obligation-free -
Get your free financial health check
A senior member of the Visory team analyzes your financials and shows where your finance function can improve. See the clarity before you commit to anything.
Free · your own numbers -
See how Visory works in practice
A walkthrough of the finance function and Insights on a practice with a payer mix like yours. If it fits, we agree a flat monthly scope.
Flat monthly fee
Get started
Know what the practice keeps, every month.
Start with a discovery call. Then a senior member of the Visory team runs a free financial health check on your own numbers and shows you where the practice’s finance function can improve.
Sources (7) · rules last checked October 9, 2026
- Internal Revenue Service, Independent contractor (self-employed) or employee?: behavioral control, financial control, and type of relationship, page reviewed May 19, 2026; 29 CFR part 795, Employee or Independent Contractor Classification Under the Fair Labor Standards Act (89 FR 1638), effective March 11, 2024; U.S. Department of Labor, Wage and Hour Division, Field Assistance Bulletin 2025-1, issued May 1, 2025.
- Internal Revenue Service, Instructions for Forms 1099-MISC and 1099-NEC (Rev. December 2026): $2,000 threshold for tax years beginning after 2025 under Public Law 119-21; Form 1099-NEC box 1a, nonemployee compensation, filed by January 31 under Internal Revenue Code section 6071(c); Form 1099-MISC box 6, medical and health care payments, including payments to corporations and by medical and health care insurers, furnished by January 31 and filed by February 28 on paper or March 31 electronically.
- Fair Labor Standards Act, section 7(a): overtime at not less than time and one-half for hours over 40 in a workweek; 29 CFR 541.304, practice of law or medicine, paragraphs (a) to (d): licensed physicians, including medical doctors, osteopathic physicians, podiatrists, dentists, and optometrists, and residents and interns, exempt without the salary requirements; eCFR current to October 7, 2026.
- 45 CFR 162.1601 (health care electronic funds transfers and remittance advice transaction), 162.1602(d) (NACHA CCD+ with the X12 835 TRN reassociation trace number; X12 835 remittance advice, on and after January 1, 2014), and 162.1603(a) (Phase III CORE EFT and ERA operating rules, including the 370 EFT and ERA reassociation rule), as amended by 77 FR 1590, January 10, 2012, and 77 FR 48043, August 10, 2012; eCFR current to October 7, 2026.
- 42 CFR 424.80, prohibition of reassignment of claims by suppliers, with the exceptions for payment to an employer and to an entity under a contractual arrangement, and joint and several responsibility for overpayments; eCFR current to October 7, 2026.
- 45 CFR 160.103, definition of business associate (including a person that provides accounting or financial services to a covered entity where the service involves the disclosure of protected health information); eCFR current to October 7, 2026.
- Physician Self-Referral Law (the Stark Law), 42 U.S.C. 1395nn, and the Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b): Centers for Medicare & Medicaid Services, Physician Self-Referral, page modified February 9, 2026; U.S. Department of Health and Human Services, Office of Inspector General, Fraud and Abuse Laws.