Why Women's Health Practice Bookkeeping Needs a Specialist
Independent midwifery, obstetrics, and gynaecology practices combine Medicare billing, private fees, GST-free health income, and often a complex mix of practitioner arrangements. Most general bookkeepers do not understand how Medicare reconciliation works or how to configure Xero correctly for a medical practice.
True Tally works with medical and allied health practices across Melbourne. We understand how Medicare payments flow, how to handle private billing gaps, and how to set up Xero correctly for a women's health practice from day one.
The Bookkeeping Complexity in Women's Health Practices
- Medicare reconciliation — Medicare claims are lodged per consultation and paid on different cycles. Bulk-billed and privately-billed consultations are handled differently. True Tally builds a Medicare reconciliation workflow in Xero for your practice.
- GST-free health services — midwifery, obstetric, and gynaecological clinical services are generally GST-free. Some ancillary services may be taxable. Xero must be configured correctly for each income type.
- Private health fund gaps — obstetric patients with private health cover receive a health fund payment plus Medicare rebate. The gap between total fee charged and combined rebates is the patient's out-of-pocket. These must be tracked correctly in Xero.
- Eligible Midwife Medicare billing — independent midwives accessing Medicare provider numbers have specific billing requirements that need to be correctly set up and reconciled in Xero.
- Practitioner pay arrangements — solo practitioners, partnerships, and group practices all have different income allocation and expense-sharing arrangements. True Tally advises on the right structure and implements it in Xero.
Medicare & Private Billing for Women's Health
Medicare reconciliation
Medicare claims tracked by MBS item number, reconciled against payments as they arrive. Bulk-billed and gap-billed consultations handled separately. Incorrect Medicare reconciliation is one of the most common bookkeeping problems in medical practices.
Private health fund billing
Obstetric procedures billed to private patients involve Medicare rebate + health fund benefit + patient gap. True Tally tracks all three components in Xero so your accounts accurately reflect what each patient owes and what has been paid.
GST-free income setup
Most women's health clinical income is GST-free. Xero must be configured with correct GST codes (HIIG for health inputs) for each income type. Incorrectly taxed health income creates BAS errors and ATO risk. True Tally configures this correctly.
Services for Women's Health Practices
- Xero setup for women's health — chart of accounts with correct GST codes, Medicare and private health fund income accounts, and bank feeds
- Medicare reconciliation workflow — structured monthly process to match Medicare payments to consultation records
- BAS lodgement — prepared correctly each quarter with agent extension dates, full input tax credit claims on practice expenses
- Monthly P&L by income source — Medicare bulk-bill, Medicare gap, private health fund, and self-pay income tracked separately for clear performance visibility
Is Your Women's Health Practice Bookkeeping Set Up Correctly?
The True Tally allied health financial audit identifies risks in your Medicare reconciliation, GST compliance, and financial reporting. Free, takes five minutes.
Start Free AuditOr book a free 20-minute call: calendly.com/truetally
Frequently Asked Questions — Women's Health Practice Bookkeeping
Are midwifery and obstetric services GST-free?
Yes. Clinical midwifery, obstetric, and gynaecological services provided by registered practitioners are generally GST-free. Some ancillary services — childbirth education classes run outside a clinical context, some lactation consulting — may be taxable. True Tally configures Xero with the correct GST treatment for each income type in your practice.
How does Medicare reconciliation work for an independent midwife?
Independent midwives with Eligible Midwife provider numbers can lodge MBS claims for antenatal, intrapartum, and postnatal care. Medicare pays a rebate per consultation item, often two weeks after the claim is submitted. True Tally builds a reconciliation workflow in Xero that tracks outstanding claims, matches rebate payments as they arrive, and records any patient gaps correctly.
How do private health fund obstetric billing gaps work in Xero?
When an obstetrician charges above the Medicare schedule fee, the patient receives a Medicare rebate (75% of schedule fee for in-hospital procedures) and potentially a health fund benefit. The gap between the total fee and combined rebates is the patient's out-of-pocket. True Tally tracks total fees, Medicare rebates, health fund benefits, and patient gaps separately in Xero so your accounts accurately reflect each patient's position.
Do I need to register for GST as an independent midwife?
You must register for GST if your total turnover is $75,000 or more. Below this threshold, GST registration is optional. Most of your clinical income will be GST-free even if you are GST-registered, which means you won't charge GST on your services but you can still claim input tax credits on your expenses. True Tally advises on the right approach for your specific practice situation.
Ready for a Women's Health Practice Bookkeeper Who Understands Medicare & Private Billing?
Book a free 20-minute call or take the free financial audit to see where your practice finances stand.
Free Financial Audit Book Free CallCall · 0468 159 950 · info@truetally.com.au