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Healthcare Practices: Setting Up Direct Deposit (2026)
Direct deposit for a healthcare practice is set up once per employee with a bank authorization, prenoted, then paid through ACH on the pay schedule the state allows, with shift differentials and on-call pay settling on the same file. BEG runs healthcare practice payroll for $45 per employee per month inside the payroll software you already use, all-inclusive, live in 3 to 5 business days.
Setup for healthcare practices
Each employee signs a direct deposit authorization with routing and account numbers, the account is prenoted with a zero-dollar test before the first live deposit, and split deposits are recorded per employee. Federal law does not let an employer make direct deposit mandatory to a bank of the employer's choosing, and most states require a paper or pay card alternative for employees who do not opt in.
Hospitals and residential care establishments may compute overtime over a fixed 14 consecutive day work period instead of the 40 hour workweek, paying time and one half for hours over 8 in a day and over 80 in the period. The employer must have a prior agreement or understanding with the affected employees before the work is performed, and cannot use both systems for the same employee.
Timing and the healthcare practice pay cycle
The ACH file goes two banking days before payday for the funds to land on the date, which means hours for physicians and nurses close earlier than the payday itself, and shift differentials for the period is settled on that file or on a documented later settlement date. Off-cycle runs, final checks and corrections use same-day ACH where the bank supports it.
The rules behind this page, with sources
General information, not legal advice. Every rule below was read on the agency page linked next to it.
- Hospitals and residential care establishments may compute overtime over a fixed 14 consecutive day work period instead of the 40 hour workweek, paying time and one half for hours over 8 in a day and over 80 in the period. The employer must have a prior agreement or understanding with the affected employees before the work is performed, and cannot use both systems for the same employee. [DOL Fact Sheet #54]
Read the full guide to how to set up direct deposit, and the rest of the healthcare practice payroll library.
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Frequently Asked Questions
Can a healthcare practice require direct deposit?
Federal Regulation E bars an employer from requiring deposit to a particular bank; the employee chooses the account. Many states add that a no-fee alternative must be offered, so a written opt-in with an alternative is the safe policy.
When does the healthcare practice pay file have to be released?
Two banking days before payday for standard ACH. Same-day ACH is available for off-cycle runs and corrections at a higher per-item cost. Hospitals and residential care establishments may compute overtime over a fixed 14 consecutive day work period instead of the 40 hour workweek, paying time and one half for hours over 8 in a day and over 80 in the period.
What does managed payroll cost for a healthcare practice?
$45 per employee per month, all-inclusive, inside the payroll software you already use, with no monthly minimum. Shift differentials, on-call pay and credentialing-based pay tiers are configured at setup, not billed as add-ons.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Healthcare Practices. BEG manages payroll at $45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: IRS: Understanding Employment Taxes
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