Why Your Accounting Team Plays a Crucial Role in Your MSO or DSO Organization

October 3, 2023

By: Lauren Guaragno

Manager, Advisory

In the world of healthcare management, MSOs (Medical Service Organizations) and DSOs (Dental Service Organizations) serve as pillars of support for medical and dental practices. These organizations offer a wide array of non-clinical services, including billing, collection, marketing, and IT support, all of which are meticulously outlined in a Management Service Agreement (MSA).

The Management Service Agreement (MSA): DSO vs MSO Perspective

The Management Service Agreement, often referred to as the MSA, builds the relationship between a DSO or MSO and a practice. It’s more than just a contract; it’s an engagement letter that leaves no room for ambiguity. This agreement outlines the services to be provided by both parties, clearly defining the services the management company will perform for its client’s professional practice.

DSO vs MSO: Key Differences

Criteria	DSO (Dental Service Org.)	MSO (Medical Service Org.)
Ownership structure	Usually owns practices	Provides support, no ownership
Control & autonomy	Lower for practitioners	Higher for practitioners
Typical services	Marketing, HR, admin	Billing, compliance, IT
Financial arrangements	Cost-plus, corporate	Flexible, professional agreement
Target audience	Dentists	Physicians, practice groups

How Management Fees Work in DSO vs MSO Models

A management fee is compensation paid by the medical or dental practice to the MSO or DSO for the services rendered. These fees typically encompass the cost of services provided plus a markup based on their estimated value, often referred to as a “cost-plus” arrangement.

Accounting for DSO vs MSO: Key Complexities

Managing the accounting for your MSO/DSO entity and/or your medical/dental professional practice entity can be challenging. Each entity requires its own financial records, with consolidated reporting playing a crucial role in understanding the overall business, not just individual legal entities.

Additionally, adhering to expense allocation guidelines within the management service agreement is vital and can be complex. It’s crucial to consider the reporting requirements for income tax filing and related implications.

How Wiss Can Assist Your MSO/DSO:

At Wiss, we bring a wealth of experience to the table, having worked closely with numerous MSO/DSO entities and medical/dental practices.

We are well-equipped to provide guidance on interpreting the intricate accounting requirements dictated by your medical service agreement and your specific legal arrangements. Furthermore, we are ready to assist you in selecting the most suitable software to meet your mandatory reporting needs, ensuring that your financial management is as seamless and efficient as possible. With Wiss by your side, you can navigate the complexities of healthcare management with confidence and precision.