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Dynamics 365 for healthcare: where the EHR stops and the ledger starts
Most healthcare finance problems we see come from asking one system to do both jobs. Vendors build the EHR and practice management platform for patients, visits, CPT codes, payer rules and denials. However, they are poor general ledgers. By contrast, Business Central is a strong general ledger and a poor place for claim-level detail.
So the clean line is a summary interface. Once a day or once a month, charges, payments, contractual adjustments and write-offs flow into Business Central. They arrive as journal lines grouped by location, provider and payer class. The accountant reconciles that journal to the practice management close report, and nobody has to key totals by hand.
A side benefit: when the ledger holds totals rather than patient rows, far less protected health information sits in your ERP. As a result, access control, sandbox copies and auditor requests get simpler to manage.
Healthcare jobs a physician group hands to Dynamics 365
Profit and loss by site
Dimensions tag every entry with clinic, department and provider. So one chart of accounts gives a P&L for each location, without a separate company per office.
Management company structures
Some groups run a management services organization beside one or more professional corporations. In that case, each entity is its own company, with intercompany fees and a consolidation for lenders and owners.
Healthcare supplies and implants in Dynamics 365
Items can require lot or serial numbers with expiration dates. So you can find a recalled lot of a device or medication across every stock room.
Imaging and lab equipment
The fixed asset module runs depreciation on scanners, chairs and lab analyzers. Also, a second depreciation book handles cases where tax and book methods differ.
Vendor bills and approvals
Approval workflows route invoices from medical suppliers and landlords to the right manager. In addition, US 1099 reporting covers contracted clinicians paid as vendors.
Budget against actual
G/L budgets by department and site let the operations lead compare spending each month to the plan the board approved.
Payroll journal import
Totals from your payroll provider post as a journal by site and department. That way labor cost reaches each clinic's P&L without payroll running in the ERP.
Deposit matching
Bank reconciliation matches daily deposits from payer remittances and patient payments against the summary entries posted from practice management.
Healthcare patient data in Dynamics 365: what to settle with counsel
- ✓We do not certify anyone as HIPAA compliant, and no software makes an organization compliant on its own. Compliance depends on your policies, contracts and people.
- ✓Microsoft's published compliance documentation lists which of its online services are in scope for its HIPAA Business Associate Agreement. Confirm that Business Central and every connected Microsoft service you plan to use appear on that list. Then have your counsel read the terms.
- ✓Decide in writing which data enters Business Central. Summary journals by site and payer usually need no patient identifiers at all.
- ✓Check every integration and add-on vendor separately: a connector or reporting tool that touches patient data needs its own agreement.
- ✓Restrict permission sets so only finance staff see ledger detail, and turn on the change log for sensitive tables.
- ✓Sandbox environments copied from production carry the same data, so treat them with the same controls.
- ✓Likewise, share Power BI reports on the ledger through workspaces with named access, not public links.
- ✓Set a rule for attachments on bills and journals. A scanned remittance or statement filed with a supplier invoice can carry patient details by accident.
- ✓Finally, agree how long you keep financial records and attached documents, and who may delete them, in line with your retention policy.
Dynamics 365 for healthcare: standard feature, add-on or other system
Dynamics 365 rollout order for a multi-site healthcare practice
- 1
Agree the reporting grid
Finance, operations and the physician owners agree which sites, departments and payer classes the reports must show. That list becomes the dimension design.
- 2
Build the summary interface
We map the practice management close report to journal lines and test it against a closed month you already trust.
- 3
Bring in vendors and assets
Open payables, supplier records and the fixed asset register move next, reconciled to the old system's balances.
- 4
Switch on supply tracking
Stock rooms that carry lot-controlled items go live with counts taken on the cutover day.
- 5
Add the next entity
With Dynamics 365 for healthcare groups, once one company closes cleanly, further entities and consolidation follow the same template.
Dynamics 365 questions healthcare finance leaders ask
Is there a separate Dynamics 365 product just for healthcare?
Yes for patient care, but not for finance. Microsoft markets Microsoft Cloud for Healthcare, which combines Dynamics 365, Power Platform and Azure features for patient engagement and care coordination. Our work sits on the finance side, where Business Central is the usual fit for small and mid-sized providers.
Can Business Central replace our practice management system?
No, and we would advise against trying. Practice management software understands payer contracts, eligibility checks, claim scrubbing and remittance files. A general ERP does not. Business Central receives the financial results of that work.
How do we get provider-level profitability?
Tag revenue and direct costs with a provider dimension. Then allocate shared costs such as rent and front-desk staff with recurring allocation journals. Financial reports and Power BI can then show contribution by provider and by site. The hard part is agreeing allocation rules with the physicians, which we help document first.
We own several practices bought over time. Do they need one company each?
If they are separate legal entities with their own tax filings, yes, each should be its own company in Business Central. You can copy shared vendors and the chart of accounts between companies. Intercompany charges post automatically, and consolidation gives the group view. If they are simply locations of one entity, a site dimension is usually enough.
What do you need from our side to scope a project?
A recent trial balance, your entity chart and a sample practice management close report. Also, a list of the reports the owners actually read. With that, the scoping call sets the plan and we put the scope in writing before any work starts. We do not quote over email.
Talk to us about your project.
Tell us what you run today and what has to change. A senior consultant replies with a written next step.