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Medical Practice Payroll

Payroll built around patient demand.

Practice nurses, reception and admin, and clinical staff, often on three different awards under one roof. On-call, after-hours and locum shifts that change week to week. We keep it all correctly classified and correctly paid.

Where it actually breaks

Three awards, one roster, zero room for error.

A practice manager checking payroll by hand has to hold three different award rulebooks in their head at once, on top of running the clinic. A locum covering an after-hours shift, a nurse staying late for an emergency, a reception staff member's role quietly expanding, none of it looks urgent in the moment. It becomes a wage claim or a Fair Work audit only once the pattern has been repeating for months.

Why this actually matters

This isn't a hypothetical risk

A Record Year for Enforcement

The Fair Work Ombudsman secured $21.2 million in court-ordered penalties in 2023-24, its highest total in 15 years. Health and community services employers are a recurring focus, precisely because mixed-award staff and irregular rosters make manual compliance genuinely error-prone.

Underpayment Is Now a Criminal Offence

Since January 2025, intentional underpayment carries criminal penalties, up to 10 years imprisonment for individuals, and for companies a fine of at least $7.825 million or three times the underpayment amount, whichever is larger.

The Cost Isn't Just the Penalty

Individual penalties can reach $16,500 per contravention, and $82,500 per contravention for an employer, on top of the back-payment itself. A single mixed-award classification error, repeated across a roster for a year, can multiply into a genuinely large liability before anyone notices.

Staff Notice, Even When You Don't

Underpayment complaints are increasingly how these cases start, an employee who suspects they're on the wrong award or missing an after-hours loading. Getting classification right isn't just compliance insurance, it's a genuine retention factor in a competitive health workforce.

Why outsource instead of hiring in-house

The real cost comparison

Costs Less Than an In-House Hire

A dedicated in-house payroll or practice manager role covering multi-award classification, on-call loadings and rostering-software mapping is a full salary plus on-costs, training and management time. Outsourcing to a specialist team costs a fraction of that, at a fixed monthly fee, with no recruitment or turnover risk.

Done by Specialists, Not a Generalist Learning on the Job

Award interpretation across practice nurses, admin and clinical staff, and on-call and after-hours loadings, is a specialised, constantly-updating skill set. An in-house hire is learning one practice's payroll from scratch; we apply this expertise daily, across multiple practices, and run structured CPD specifically to keep it current.

Real Value, Not Just a Compliance Box to Tick

Getting practice payroll right protects you from Fair Work penalties, but it also protects staff trust and retention in a competitive health workforce. Outsourcing this properly means your time goes back into running the practice, not chasing a pay run or an award update.

What we handle

Four jobs that keep medical practice payroll correct

01

Correct Classification Across Every Award

Practice nurses, reception and admin, and clinical support staff classified under the award that actually applies to their role, reviewed as responsibilities change, not set once and left alone.

02

Rostering Software Mapped to Xero

Whatever system your practice rosters and logs time in, mapped to the correct Xero pay items, so on-call, after-hours and locum shifts flow through as what they actually were, not flattened into standard hours.

03

Ongoing CPD on Award Changes

We run structured internal CPD covering the awards relevant to medical practice staff, tracking Fair Work Commission determinations and annual wage reviews, so a rate change shows up in your pay run the cycle it takes effect.

04

Super, STP and the Full Pay Run

Superannuation guarantee timing in line with Payday Super requirements, Single Touch Payroll reporting every pay run, and leave accrual across a mixed full-time, part-time and casual team, handled end to end as one accountable service.

Who this is for

General practice through to specialist clinics

General PracticeSpecialist ClinicsDay SurgeriesMedical CentresSkin & Cosmetic ClinicsRadiology & Pathology Practices

Most practices we work with hit real payroll complexity once staff span more than one award and rosters start including after-hours, on-call or locum coverage on a regular basis.

Part of True Tally Bookkeeping

A payroll team that understands how a practice actually rosters

This is a dedicated payroll service from True Tally Bookkeeping, an Australian Registered BAS Agent and Xero Certified Advisor. Full bookkeeping and BAS support for medical practices is handled the same way, by the same team, if you need it.

There are no silly questions. You should be across your payroll numbers at all times, our job is to make that easy.

"Finally, someone who understood our roster wasn't a nine-to-five one."
Medical Practice Manager
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Allied Health & Medical Bookkeeping, our full bookkeeping service → Payroll Management for Australian Small Business, the full guide → Add full bookkeeping support alongside payroll →
Straight answers

Practice managers ask us…

A single practice often runs practice nurses, reception and admin staff, and allied health or specialist staff under different Modern Awards at once, plus on-call and after-hours arrangements. Each has its own penalty rates and allowance rules, and a roster built around patient demand rather than fixed shifts makes manual checking genuinely error-prone.

Staff classified under the wrong award for their actual duties, on-call or after-hours loadings calculated on the base rate instead of the correct rate, and a roster change, a locum covering a shift, a nurse working late, not correctly reflected in the pay run.

We run internal CPD sessions covering the awards relevant to medical practice staff, tracking Fair Work Commission determinations and annual wage reviews, so classification and rate changes are reflected in your payroll from the pay cycle they take effect.

Yes. We map each shift type in your rostering or timesheet software to the correct Xero pay item, so after-hours, on-call and standard shifts flow through to payroll accurately rather than being flattened into ordinary hours on import.

A fixed monthly fee based on headcount and how many award classifications and rostering systems need to be reconciled into Xero. No surprise invoices. Book the free consult and we'll give you an actual number.

Free 15-minute consult

Not sure your practice payroll would survive a closer look?

We'll review your current award classifications, on-call and after-hours handling, and how your rostering software lines up with Xero, then tell you exactly what we'd change.

Book My Free Consult or call 0468 159 950
📞 Call True Tally on 0468 159 950