Managed Payroll · Healthcare
24/7 schedules, shift differentials, clinical overtime rules, and multi-state licensure make healthcare payroll the most complex in any industry. We manage it all at $25-$45 per employee per month -- fully managed, no migration required.
See your exact monthly & annual price - no call required
The Cost of Running It Yourself
How It Works
We map your current payroll process, employee roster, and complexity. You get a fixed monthly cost -- no surprises.
We configure and run your first payroll cycles. No migration required -- we work in your existing system. Transition takes 30-60 days.
Every pay cycle, every filing, every compliance update -- fully managed by BEG. Your team touches nothing.
Compliance Requirements
Healthcare organizations pay shift differentials to compensate clinical staff for working undesirable hours. A night differential of $3-$5 per hour, a weekend differential of $4-$6 per hour, and a holiday premium of 1.5x to 2.5x base pay are common structures -- but rates vary by classification, and in unionized facilities they are set by collective bargaining agreement. On-call pay follows different rules: on-call time (waiting at home ready to be called in) may or may not be compensable under the FLSA depending on how severely the employer restricts the employee during that period. Call-back pay (hours actually worked after being called in) is always compensable and may trigger overtime calculations separately from the regular shift hours. Payroll must handle on-call and call-back correctly to avoid DOL wage and hour exposure.
Many healthcare organizations pay differently based on education level and clinical certifications. A BSN-credentialed RN may earn a base wage premium over an ADN-credentialed RN in the same role. Specialty certifications -- CCRN, CEN, PALS, CCP, and others -- add hourly or salary differentials on top of base wages. Managing credential-based tiers requires the payroll system to be configured with each credential and its pay adjustment, updated when employees earn or renew credentials, and audited to ensure the correct tier is applied to each clinical staff member. When an employee lets a certification lapse, the differential must be removed promptly from payroll.
HIPAA applies to payroll records at healthcare organizations because payroll files often contain or are linked to protected health information -- employee names tied to medical leave records, ADA accommodation documentation, workers compensation injury records, and FMLA-related absence records. Payroll system access that is not appropriately restricted creates HIPAA exposure. BEG manages payroll under access protocols consistent with healthcare employer obligations, limiting access to designated personnel with legitimate need and maintaining records under policies appropriate for a HIPAA-covered or business-associate environment.
Per-diem clinical staff -- nurses, technicians, and allied health workers called in on an as-needed basis -- have variable hours, irregular pay periods, and may work across multiple facilities within the same organization. Travel nurses and allied health travelers engaged through staffing agencies are typically the agency employees -- but some healthcare systems directly employ travel staff under a travel contract model. For directly employed travelers, the tax-home rules, per-diem reimbursement tax treatment, and state tax registration for temporary workers must all be managed correctly. BEG handles per-diem and travel staff payroll under the correct treatment for each employment arrangement.
Hospital systems with multiple clinics, urgent care centers, and physician practices often have clinical staff who rotate between facilities in the same pay period. This creates questions about which cost center captures the labor expense, whether different union agreements or wage scales apply at different facilities, and whether multi-site work triggers any tax or licensure obligations. BEG configures payroll to track facility-level labor allocation so cost reports reconcile at the facility and cost-center level without requiring manual adjustments after each pay cycle.
Who This Serves
Multi-provider practices with clinical and administrative staff, productivity-based physician compensation, and credential-based pay differentials for clinical support staff.
Production-based associate dentist compensation, clinical staff shift differentials, and multi-location staff scheduling that affects payroll allocation.
Per-diem staff management, on-call scheduling for surgical cases, and credential-based RN and surgical tech compensation tiers.
Field-based clinical staff with variable hours, mileage reimbursement, and multi-county service area state payroll tax compliance.
Clinical staff with varied licensure levels (LCSW, LPC, Psy.D., MD) that affect compensation tiers, billing rates, and supervision requirements.
Large enough to need specialized clinical payroll management, small enough that an internal payroll specialist who understands healthcare compliance is difficult to hire and retain.
What You Get
Common objection: "Switching payroll systems is too disruptive."
We do not require you to switch platforms. BEG operates as your managed payroll team inside your current system. If you want to move to a better platform, we can handle that too -- but it is never a requirement to get started.
Common objection: "Payroll services always add fees for every little thing."
The $25-$45 PEPM rate is all-inclusive: payroll processing, tax filing, compliance updates, year-end W-2s, and support. One number, everything included.
Common objection: "Payroll vendors disappear after onboarding."
Your BEG payroll specialist is your ongoing contact. When something changes -- a new hire, a state registration, a compliance update -- you send one message. There is no ticket queue, no chatbot, and no calling a 1-800 number. Your team has a real person who knows your account.
The Math on Waiting
An internal payroll specialist at your healthcare organization costs $60,000-$100,000 per year in fully-loaded compensation. Fully managed payroll at $25-$45 PEPM on a 50-person team costs $15,000-$27,000 per year. Every month your team handles payroll manually is a month of compliance exposure, corrections, and staff time that should be going to patient care -- not spreadsheets.
Your Next Transition Window
Payroll transitions take 30-60 days. If you want a clean cutover at Q3, Q4, or January 1 -- the window to start is now. Companies that miss the quarter-start timing typically wait another 3 months. The savings you defer are gone for good.
15 minutes. We scope your payroll, give you a fixed monthly cost, and show you what transition looks like.
FAQ
RNs, LPNs, clinical staff, PRN employees, administrative staff, and all healthcare team members across any org size.
No. We operate as your managed payroll team inside your existing system. Migration is an option, never a requirement.
Everything: payroll processing, federal and state tax filing, compliance updates, year-end W-2s, and dedicated BEG support.
30-60 days from scope review to first managed payroll run. We handle setup, testing, and go-live. Your team reviews and approves before anything goes live.
Your rate adjusts with headcount. Adding or removing employees updates your monthly cost at the same per-employee rate. No contracts to renegotiate.
BEG configures shift differentials for each clinical role -- night, weekend, and holiday rates -- and applies them automatically based on the hours worked and shift schedule. In unionized facilities, differential rates are taken from the applicable collective bargaining agreement. Differential pay is included in the regular rate for overtime calculations per FLSA rules.
Yes. Payroll files at healthcare employers often contain or are linked to protected health information -- medical leave documentation, ADA accommodations, FMLA records, and workers compensation records. BEG manages payroll access under policies appropriate for a HIPAA-sensitive environment, limiting system access to designated personnel with a legitimate need.
Per-diem staff have variable hours and may not work every pay period. BEG tracks per-diem staff hours correctly across irregular schedules, ensures ACA measurement period hours are tracked for eligibility purposes, and applies the correct tax treatment for any per-diem reimbursements paid alongside hourly wages.
Yes. BEG configures payroll to track labor allocation by facility or cost center within the same organization. Clinical staff working at multiple locations in the same pay period are allocated correctly so facility-level cost reports reconcile without manual adjustments after each cycle.
BEG configures payroll to sync with the time and scheduling data your facility already uses, so shift differentials, on-call hours, and per-diem or PRN shifts flow into payroll without manual re-entry. For multi-location healthcare organizations, that sync has to hold up across every site: a PRN nurse who picks up a shift at a second facility should show up correctly in that facility's labor cost report, not just get paid. BEG configures this scheduling-to-payroll connection during implementation and manages it as staff schedules and facility rosters change.
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