Bookkeeping & CFO Advisory
Your books, read out loud.
Most practice owners have a bookkeeper and no one to interpret the results. MedPraxis closes that gap — accurate books every month, and a CFO who sits down and reads them with you, so you know what the practice is actually earning and where the next dollar should go.
Dental · Veterinary · Chiropractic · Medspa
84% collection rate. Down 5 pts since March — the gap is aging claims, not pricing.
Two points above where this practice should sit. Staffing, not rent.
This is the conversation, not the report. We walk it with you every month.
The gap
A bookkeeper emails you a P&L. Nobody tells you what it means.
You went to clinical school, not business school. Nobody taught you to read a profit and loss statement, and the person keeping your books was never hired to explain one. So the reports arrive, they get filed, and the real questions — is this month good, should I hire, can I afford the second operatory, why is cash tighter than revenue suggests — go unanswered.
MedPraxis does both halves. We keep books built for how a practice actually earns, then we get on a call every month and read them with you. Not a dashboard. A conversation, with someone who has seen a few hundred practices and can tell you where yours is leaking.
Two services
What we do.
A foundation you can trust, and someone to interpret it. Most owners need both; a few only need the first.
Foundation
Bookkeeping & Monthly Close
Transactions categorized to a practice-appropriate chart of accounts, bank and merchant reconciliation, payroll and provider comp tracked cleanly, deferred revenue handled correctly, and a closed set of financials by the same date every month.
Bookkeeping & close →Interpretation
CFO Advisory
The monthly read, margin by provider and service line, a rolling cash forecast, hiring and equipment decisions modeled before you commit, and an owner-earnings picture that tells you what the practice is really worth to you.
CFO advisory →Who we serve
Four practice types. Four different financial models.
These aren't interchangeable. Membership plans, inventory, care packages, and pre-paid treatment series each break a generalist's books in a different place.
Dental practices
Fee-for-service plus insurance, in-house membership plans as deferred revenue, hygiene as a profit center, and heavy equipment capital.
VeterinaryVeterinary practices
Real inventory and retail margin, pharmacy, wellness plans billed monthly, and DVM production comp that hides in payroll.
ChiropracticChiropractic practices
Care packages paid up front and delivered over months — the single most commonly mis-booked item in practice accounting.
MedspaMedspa & aesthetics
Cash-pay treatment series, injectable inventory that expires, memberships, and gift-card liability that most books ignore.
The numbers
What we watch, every month.
Beyond clean books, the measures that tell you whether the practice is actually profitable — and which lever to pull when it isn't.
How it works
Onboarding is four steps.
The call
Twenty minutes. You tell us about the practice, we tell you honestly whether we're the right fit and what we'd charge. No pitch deck.
Diagnostic & cleanup
We take your file apart, tell you what's wrong with it, and fix it. Most practices need 30 to 60 days of cleanup before the numbers can be trusted.
The close rhythm
Books close by the same date every month. You get a statement package that's readable, not a QuickBooks export.
The monthly read
We get on a call and walk it with you. What changed, what it means, what to do about it before next month.
Questions
Frequently asked.
How is practice bookkeeping different from regular bookkeeping?
A practice earns through insurance, patient or client payments, and packages that are often paid before the work is delivered — so cash lags production and deferred revenue is real. Books have to reflect that, plus provider-level and service-line profitability and clinical payroll. A generalist who treats a practice like a retail business misjudges the timing and the provider economics.
Do we need clean books before the CFO work starts?
Yes. Forecasting built on unreliable data is guesswork. If the books need attention first, we say so plainly and get the foundation right before layering strategy on top — usually a cleanup in the first 30 to 60 days.
What actually happens in the monthly meeting?
We close the month, then walk the statements with you line by line: what changed, what it means, and what decision it points to. You leave knowing your production-to-collections gap, your margin by provider or service line, and where the next dollar should go.
Do you replace our bookkeeper?
Usually. Most owners come to us with a bookkeeper who records transactions and no one who interprets them. We do both — the close and the read — so there is one team accountable for whether the numbers are right and what they mean.
How do you scope an engagement?
After the first call and a look at your file, you get a written scope and fee — what we will do, on what cadence, and what it costs, before you commit to anything ongoing. Scope depends on practice size and complexity: transaction volume, number of providers, locations and entities, whether you carry inventory, and how much deferred revenue the model involves. No surprise scope later.
Book a call
Let's talk about your practice.
Twenty minutes, no obligation. We'll tell you honestly whether we can help — and what cleaner, practice-aware books would change for you.
Book a call