Payroll
Payroll for your front desk, clinical staff, and providers, run through Gusto and set up correctly in every state where your people work.
What This Is
We run payroll for everyone in your practice. That includes the front desk, medical assistants, nurses, billing staff, therapists, and the providers themselves. Hourly, salaried, part-time, and per diem people all go through the same system on the same schedule.
Payroll runs through Gusto, and your books are kept in QuickBooks Online, so the two stay connected. Gusto handles the tax deposits and filings. We make sure the information going into it is right. That means correct hours, correct pay rates, correct withholding, and correct state registrations before anyone gets paid.
What Gets Handled
What Gets Handled
Regular pay runs for staff and providers. New hire setup and state new hire reporting. Federal and state withholding. Payroll tax deposits and quarterly filings. State unemployment accounts. W-2s at year end. Final paychecks when someone leaves. Questions from employees about their pay stubs.
Any State
Any State
A practice in Kansas City can easily have staff living in Missouri and working in Kansas. A behavioral health group might have a telehealth therapist in Colorado. A billing coordinator might work from home three states away. We register the practice where it needs to be registered and withhold for the right state, so each person is taxed correctly.
Why This Matters
Payroll is the one part of your finances your whole team sees. A wrong paycheck gets noticed the same day. Your medical assistant who is short forty dollars has to bring it up with you, and you have to figure out what went wrong in between patients. Do that a few times and people start to wonder whether the practice has its act together.
The tax side is less visible but more expensive. A missed deposit or a late quarterly filing brings penalties and interest that grow quietly until a notice shows up. And the rules change depending on where your people live and work. Hiring one remote employee in a new state can mean new registrations, new withholding rules, and new filings that nobody told you about.
The Multi-State Gap
The Multi-State Gap
Many practices hire their first out-of-state provider or remote staff member and keep running payroll the same way. Taxes keep going to the home state. Nobody registers in the new one. A year later the other state sends a letter asking for back taxes, and the employee finds out their W-2 was wrong when they file their own return.
The Evening Pay Run
The Evening Pay Run
A lot of practice owners run payroll themselves after the last patient leaves. They check timesheets, fix missed punches, add a bonus, and hope the tax settings are still right. It works until it doesn’t. It also takes a few hours every pay period that you could spend on your patients or your family.
What Changes
Payroll runs on schedule without you building it. You review and approve, and your team gets paid the right amount on the right day. When someone has a question about their check, they have a clear answer. When you hire someone new, the setup is done before their first shift.
Growing into a new state stops being a paperwork problem. You can hire the provider you want or bring on a remote biller without worrying about what it means for your filings. If a payroll tax notice ever arrives, our enrolled agents handle it with the agency directly.
Payroll That Matches the Books
Payroll That Matches the Books
Because we run both your payroll and your bookkeeping, wages and payroll taxes land in QuickBooks the way they should. Your monthly numbers show what staffing actually costs, by role if you need it. There is no gap between what payroll says and what your books say at tax time.
Room to Grow
Room to Grow
Whether you have six employees or forty, the process stays the same. If provider or clinician pay depends on production or sessions, our Provider Pay Calculations and Clinician Pay services work out those amounts from your existing agreements and feed them straight into payroll. You don’t have to calculate anything by hand.
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