Peer Group: Medical Practice
What most medical practices in Germany actually use: traditional banking, DATEV-based accounting, and payroll management. Medical practices in Germany almost universally use DATEV.
How This Stack Works
Fyrst processes patient payments (insurances, copays) → Transactions auto-sync to DATEV via Steuerberater → Steuerberater manages all accounting in DATEV system → Sage Lohn processes monthly physician and staff payroll → Annual tax return filed by Steuerberater
App Compatibility
How well the apps in this stack work together
3/6 pairs known
Integrations
Notes
No known integration between fyrst and sage-lohn
No known integration between datev and sage-lohn
No known integration between sage-lohn and finban
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
Trusted by fellow physicians across Germany for practice banking. Fyrst integrates with DATEV and meets healthcare compliance requirements, with Deutsche Bank backing that provides the institutional trust medical professionals expect.
When to switch
Only if your practice expands internationally or requires specialized healthcare banking features.
Why this choice
The industry standard that virtually all German medical practices rely on. Fellow physicians trust DATEV through their Steuerberater for complete practice accounting. Battle-tested in healthcare compliance where there is no room for error.
When to switch
Never switch for a medical practice in Germany—this is mandatory compliance.
Alternatives
Why this choice
The most common choice among German medical practices for staff payroll. Fellow physicians trust Sage Lohn for physician contracts, associate agreements, staff wages, and the specific medical labor regulations that govern healthcare facilities.
When to switch
Only if you fully outsource payroll to a specialized medical practice management company.
Alternatives
Accountable Tax Service
Combination of tax software and human tax advisors for freelancers.
Why this choice
Popular among similar medical practices because they specialize in physician taxation. Fellow doctors recommend them for income splitting, medical equipment depreciation, continuing education deductions, and healthcare-specific regulations.
When to switch
Only if your practice structure changes significantly or your Steuerberater no longer specializes in medical practices.
Alternatives
Why this choice
Essential for medical practices managing delayed insurance reimbursements against fixed staff and equipment costs. Fellow physicians use finban to forecast cash positions during KV payment cycles and plan major equipment purchases without liquidity stress.
When to switch
N/A
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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