Physician bookkeeping: MPC books that reconcile to every OHIP remittance

Your MPC's books are more than one deposit a month

OHIP pays once a month, and it is tempting to treat that deposit as the whole story. It is actually the last step of a pipeline: services rendered, claims coded and submitted, some paid in full, some cut back, some rejected outright. Books that begin at the deposit can never tell you how much of your work went unpaid — and for a busy practice, that number is rarely zero.

We record gross billings as revenue with a claims receivable, then clear that receivable against the monthly remittance advice. The result is a ledger where billed, paid, and outstanding are three distinct figures your medicine professional corporation can actually act on.

Remittance reconciliation: billed, paid, rejected, stale-dated

Each month we match the RA against submitted claims, whether you bill through your EMR over MC EDT or through a billing agent. Underpayments and error codes get flagged back to whoever does your billing while the claims can still be corrected — Ontario gives you six months from the date of service to submit, and a rejected claim that sits past that window becomes a permanent write-off.

• Rejection tracking — a running view of rejected dollars, so a coding problem shows up in month two instead of at year-end.
• Agent statements — if a billing agent takes a percentage, we book revenue gross and their fee as an expense. Netting it away hides your true cost of getting paid.
• Write-off discipline — stale or abandoned claims are written off deliberately, dated and documented, never silently absorbed.
• Locum tracking — physicians working across several clinics or hospitals get a stream per site, so each location's billings, overhead, and travel stand on their own.

Not all practice income is OHIP — or HST-free

Most physicians have three or four income streams beyond fee-for-service, each with its own bookkeeping and GST/HST character. Mixing them into one revenue line makes both the tax treatment and the planning picture blurry.

Overhead-share arrangements need their own ledger discipline

Group practice overhead is where physician books most often go muddy. Whether you pay the clinic a percentage of billings or a fixed cost share, we record your revenue gross and the overhead charge as its own expense, then reconcile it monthly against the clinic's statement — so a percentage that quietly drifts upward gets noticed.

If you are on the other side of the arrangement and collect overhead from other physicians, those charges are usually taxable supplies even though your clinical income is exempt. That combination catches many principals off guard, and it is exactly the kind of thing month-to-month books should surface rather than a CRA letter.

Month-end that feeds real planning

CMPA dues, college fees, CME travel, and private health premiums each have their own deductibility story, so we keep them in distinct accounts rather than one professional-fees bucket. If the MPC holds an investment portfolio, we record the activity monthly and reconcile the broker statements, because passive income inside the corporation can grind down access to the small business deduction — a number your accountant needs current, not reconstructed.

Salary versus dividends, the corporate investment account, passive-income limits on the small business deduction — every one of those decisions is made from the MPC's books, and a backlog of unreconciled months means planning from stale data. We close monthly, keep shareholder transactions out of the operating accounts, and hand your tax planner numbers that are current. See our tax services for the planning layer, and if your history includes US residency years, fellowship income, or American retirement accounts, our cross-border tax guide for physicians covers the reporting your books need to support.