Medical practices & clinics
Books and taxes for occupational health clinics.
Employers paying on net-30 invoices, workers compensation claims on their own timeline, and DOT physicals tied to a certification you renew every few years. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
October came in at $29,500. A trucking company's monthly invoice for DOT physicals and drug screens paid on time, so I matched it to what was actually billed, not just what landed.
- Meridian Trucking net-30 invoiceEmployer contract revenue
- Workers comp claim payoutWorkers compensation reimbursements
- DOT examiner registry renewalDOT certification costs
- Drug testing panel suppliesDrug testing supplies
- Clinical staff payrollClinical wages
Why your books are different
An occupational health clinic's books go wrong because employers are your real customer.
You're not billing insurance or collecting from patients at the front desk, you're invoicing employers on a net-30 or net-60 cycle, filing workers comp claims on a completely different system, and keeping a federal certification current. A generalist assumes a normal medical billing pattern and misses all of it.
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1
Employer invoices pay on their own schedule
A trucking company or staffing agency sending employees for physicals and drug screens typically pays on a net-30 or net-60 invoice cycle, a normal delay that can look like a slow month if it isn't tracked against when the invoice was actually sent.
What we doMatches employer contract revenue to the invoices it came from, so a normal payment delay reads as expected instead of alarming. -
2
Workers compensation is a completely different payer system
Workers comp claims run through a state-specific system with its own timelines and rules, separate from regular health insurance, and blended with employer invoice revenue it's hard to tell which payer relationship is actually working well.
What we doKeeps workers compensation reimbursements in their own line, apart from direct employer contract revenue, so each payer type shows its own pattern. -
3
DOT certification is a recurring cost with a real deadline
A medical examiner performing DOT physicals has to maintain a federal certification that renews every few years, a real cost that's easy to forget about until it's due.
What we doKeeps DOT certification costs in their own line, so the renewal shows up as an expected cost rather than a surprise. -
4
Drug testing volume swings with employer contracts
Drug testing panel costs rise and fall with how many employer contracts are active and how much volume they're sending, and without tracking that connection, testing costs can look erratic.
What we doTracks drug testing supply costs against employer contract revenue, so a volume swing reads as a pattern tied to your contracts, not a random cost spike.
Your categories
The categories Gus keeps for an occupational health clinic.
Set up once for how employer contracts, workers comp, and DOT exams all get paid. You never pick a category. He does, and an accountant checks it.
Money in
- Employer contract revenueNet-30 or net-60 invoices billed to trucking companies, staffing agencies, and other employers.
- Workers compensation reimbursementsClaims paid through the state workers comp system.
- DOT physical feesCommercial driver physicals, billed to the employer or paid directly by the driver.
- Direct-pay physical and screening feesAny physicals or drug screens paid directly rather than invoiced.
Money out
- DOT certification costsNational registry renewal fees for certified medical examiners.
- Drug testing suppliesTesting panels and collection supplies used for employer-sent screens.
- Clinical wagesMedical examiners and clinical staff performing physicals and screens.
- Rent and utilitiesClinic space for exams and testing.
- Malpractice insuranceAnnual or quarterly premiums for the practicing clinicians.
- Practice management softwareScheduling, employer invoicing, and results tracking tools.
- Marketing to employersOutreach to trucking companies, staffing agencies, and local businesses.
What we watch for you
- Invoice aging by employer
Which employer accounts are paying on time and which are running behind, tracked from what's actually landed.
- Workers comp versus contract mix
How much revenue comes from workers comp claims versus direct employer invoicing.
- Testing cost per contract
How drug testing supply costs track against the employer contracts driving that volume.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things occupational health clinic owners ask Gus.
Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.
I match employer revenue to the invoices it came from, so I can tell you exactly how late that one is running. A single slow payer isn't unusual, but I'll flag it if it keeps happening.
It can be, workers comp runs through its own state system with its own timeline. I keep the two revenue types apart so you can see that pattern clearly instead of it blending together.
I keep certification costs in their own line, so the renewal fee shows up as an expected cost rather than a surprise expense when it lands.
The tax side
The tax side of an occupational health clinic.
Most of what matters here is tracking employer invoice timing and keeping DOT certification costs visible.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Employer invoice revenue timingEmployer contract revenue is generally income when the service is performed and billed, not simply when the invoice is paid, which matters for accurate financial reporting even with net-30 or net-60 terms.
- DOT certification and licensing costsNational registry renewal fees and related certification costs are generally deductible as ordinary business expenses in the year they're paid.
- The pass-through deductionMost owners can take up to 20 percent of business profit off their taxable income. It comes out right when employer, workers comp, and direct-pay revenue are all kept straight all year.
- Contract or covering examinersA medical examiner covering your clinic occasionally who bills you directly is often a contractor and gets a 1099-NEC if you pay them $2,000 or more in 2026, due January 31.
Deductions occupational health and DOT physical clinics miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Drug testing supplies
- DOT certification and registry fees
- Malpractice premiums
- Practice management software
- Marketing to employers
- License and registration renewal
- Scrubs and clinical apparel
- Biohazard disposal
- Continuing education for examiners
- Employer invoicing and collections software
General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.
All year, not just April
An occupational health clinic year, kept every month.
Employer contracts, workers comp claims, and DOT certification renewals each run on their own schedule. Your taxes come on a fixed one. Your team keeps you ahead of all three. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Plan the year
Last year's return gets started, and you get a monthly set-aside so April is already handled, even with employer invoices still aging.
- April
Filed. Done.
Your return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where you stand, what you will owe, and whether employer contract volume or workers comp claims changed the number.
- October
Before year end
Gus looks at anything worth doing before December, including whether any DOT certification renewals are coming up.
What you get
What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.
Book a call- Monthly bookkeeping
Every transaction sorted into categories set up for occupational health and DOT physical clinics. You never categorize a thing.
- An accountant checks every transaction
Real review, every month, before your books close. Not a spot check.
- Your business tax return, filed
Prepared, reviewed, and signed by that same accountant every year.
- The monthly number
What you made, what you spent, what to set aside for taxes.
- Your own bookkeeper
A real person assigned to your business, in the app whenever you need them. No hold music.
- On your books all year
Every month, not just in April. Your team speaks up whenever something is worth your attention.
- Cancel any time
No contract. No cancellation call. Your books are yours.
Straight answers
Questions occupational health clinic owners ask first.
Do you handle employer invoicing or workers comp claims for us?
No. Gus does not handle billing, claims submission, or invoicing of any kind. Your practice management software still handles that. Gus works from what actually lands in your bank account.
How do you know if an employer client is paying on time?
Gus matches employer contract revenue to the invoices it came from, so you can see which accounts are current and which are running behind.
Workers comp claims seem to take longer to pay than our direct employer contracts. Does that matter for the books?
Gus keeps the two revenue types in separate lines, so that difference in timing shows up as a clear pattern instead of blending into one number.
My DOT medical examiner certification needs renewing soon. Does Gus track that?
Gus tracks the cost of the renewal in its own line so it's a visible, expected expense, though keeping your actual certification current is on you.
Our drug testing costs seem to swing a lot month to month. Is that normal?
It often tracks with how much volume your employer contracts are sending. Gus tracks testing costs against contract revenue, so the swing reads as a pattern tied to your business, not a random spike.
Is a real accountant checking my books?
Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.
What does it cost, and can I cancel?
It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.
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What makes a bookkeeper worth paying for Every business we keep books for
Book a call
Pick a time. That's the whole signup.
Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.
- $197 a month to start
- An accountant on every transaction
- Cancel whenever