Finance Stack for German Medical Practice
Stack for doctors, therapists, and medical practices. Kassenabrechnung, private billing, medical regulations.
How This Stack Works
KV payments + private bills → Bank receives → DATEV for accounting → Sage for staff payroll → Specialized Steuerberater
App Compatibility
How well the apps in this stack work together
6/10 pairs known
Integrations
Notes
No known integration between fyrst and sage-lohn
No known integration between lexoffice and sage-lohn
No known integration between datev and sage-lohn
+ 1 more notices
Apps & Services in This Stack
Each category below shows the recommended app or service and alternatives. Click on any item to learn more.
FYRST
Deutsche Bank's digital business banking offering. German reliability with modern features.
Why this choice
FYRST or Sparkasse provides the established banking relationships that medical practices need for receiving quarterly KV-Abrechnungen (Kassenärztliche Vereinigung payments) and managing practice financing. Traditional banks understand the unique payment patterns of medical practices with delayed KV settlements and offer appropriate credit facilities for equipment purchases or practice acquisition. Solid documentation and audit trails meet the professional requirements expected of medical practitioners.
When to switch
N/A
Alternatives
lexoffice
Popular German accounting software by Lexware. GoBD-compliant, great for small businesses.
Why this choice
lexoffice complements practice management software by handling private patient billing according to GOÄ (doctors) or GOZ (dentists) fee schedules, with proper Steigerungsfaktoren and detailed position descriptions patients expect. The software manages the payment tracking for private invoices that KV billing through Praxissoftware does not cover, and handles IGeL (individual health services) billing with correct USt treatment. Clear patient-facing invoices with proper medical service descriptions maintain professional standards.
When to switch
Specialized medical billing software.
Why this choice
DATEV provides the professional accounting infrastructure medical practices need, handling the unique timing of KV payment receipts (quarterly, with variable Honorarverteilung) and the mix of USt-exempt medical services with taxable IGeL offerings. The software manages proper documentation for expensive medical equipment depreciation (often 8-15 years) and tracks the various revenue streams practices typically have. Direct Steuerberater collaboration through DATEV is essential given the complexity of medical practice finances.
When to switch
N/A
Alternatives
Why this choice
For medical practices with quarterly KV payment cycles and ongoing operational costs, finban provides essential cash flow visibility. Connect your bank to see upcoming staff payroll, equipment leasing, and KV settlement timing, helping you bridge the gaps between quarterly Honorarverteilung payments.
When to switch
N/A
Why this choice
Sage Lohn manages the specialized payroll for medical practices including MFA (Medizinische Fachangestellte) with their specific Tarifvertrag, proper handling of Bereitschaftsdienst and Überstundenzuschläge, and tracking of required certifications and training hours. The software handles the mix of clinical and administrative staff with different collective agreements and manages the Fortbildungspflicht documentation required in healthcare. Automated Krankenkassen and Berufsgenossenschaft reporting meets the strict compliance requirements.
When to switch
N/A
Accountable Tax Service
Combination of tax software and human tax advisors for freelancers.
Why this choice
A Steuerberater specialized in Heilberufe understands the unique Freiberufler status of physicians, proper USt exemption for medical services under §4 Nr. 14 UStG, and taxation of non-medical IGeL services. They optimize the significant equipment depreciation common in practices, navigate Praxisübernahme or BAG (Berufsausübungsgemeinschaft) structures, and handle the complex KV income timing for proper tax year allocation. Their expertise ensures proper treatment of Honorarverteilung and protects against common compliance pitfalls.
When to switch
Find one specializing in Heilberufe.
About This Business Type
Running a medical practice in Germany involves a unique financial landscape where most revenue comes through Kassenärztliche Vereinigung (KV) settlements for statutory health insurance patients, supplemented by private patient billing (Privatpatienten) and individual health services (IGeL). The accounting requirements differ significantly from typical businesses. KV settlements arrive quarterly, based on patient contacts and procedures, with complex point value calculations that change regularly. Private patients are billed according to GOÄ (Gebührenordnung für Ärzte), with various multiplier factors depending on service complexity. Your accounting must track these revenue streams separately for both financial clarity and regulatory compliance. Practice expenses include staff (often the largest cost), equipment and depreciation, premises, and medical supplies. Many practices struggle with cash flow due to the quarterly KV payment cycle. Understanding your revenue mix (GKV vs. PKV vs. IGeL) and optimizing where allowed helps practice sustainability.
Common Challenges
- Quarterly KV settlement cash flow gaps
- GOÄ billing and collection for private patients
- Staff-heavy cost structure management
- Medical equipment investment and depreciation
- Regulatory compliance documentation
Compliance Requirements
- KV settlement accounting and timing
- GOÄ billing requirements
- Medical equipment depreciation (AfA)
- IGeL service documentation
- Practice revenue is VAT-exempt (§4 Nr. 14 UStG)
Why This Stack Works
- KV settlement tracking
- Private patient billing integration
- Staff scheduling and payroll
- Equipment asset management
- Medical-compliant documentation
Frequently Asked Questions
How does KV settlement work for medical practice accounting?
The KV pays quarterly based on services rendered to statutory health insurance patients. You submit service documentation, they calculate payment based on current point values. Payment arrives 2-3 months after quarter end. Track as accounts receivable until received. The amount varies based on services, budget constraints, and regional factors—not a fixed fee per patient.
Are medical practices subject to VAT in Germany?
Medical treatment services are VAT-exempt under §4 Nr. 14 UStG. This means you don't charge VAT on patient fees, but also can't reclaim VAT on purchases. Some ancillary services (cosmetic procedures, some IGeL) may be VAT-applicable—consult your Steuerberater. Practice supplies and equipment purchases include VAT you cannot recover—factor this into pricing and purchasing decisions.
How should doctors track IGeL (individual health services)?
IGeL are out-of-pocket services not covered by insurance. Document: patient consent form, service description, agreed price (often based on GOÄ factors). Track separately from KV and private insurance billing. IGeL income is immediate (not quarterly settlement)—good for cash flow. Some practices grow IGeL significantly; track which services have demand and profitability.
What practice management software integrates with accounting in Germany?
Systems like Medistar, Turbomed, or Doctena handle patient management and billing. Many export to accounting software (DATEV, lexoffice) or your Steuerberater directly. The PVS (Praxisverwaltungssystem) typically handles KV submission and GOÄ billing. Accounting receives aggregated revenue data. Don't try to track individual patient billing in accounting—let PVS handle that, export totals.
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