Defined
Practice bookkeeping, defined.
Practice bookkeeping is the discipline of recording revenue that arrives on a delay through insurance and patient or client payments, treating pre-paid packages and memberships as the deferred revenue they are, tracking provider compensation cleanly enough to know true margin, and reconciling the accounting to the practice management system rather than running two sets of numbers that never agree.
A generalist bookkeeper who treats a practice like a retail business gets three things wrong every time: they book collections as production, they recognize package revenue on receipt, and they bury provider comp in a single payroll line. Each one makes the practice look more profitable than it is.
Included
What's in the monthly close.
- Transaction categorizationEvery transaction coded to a chart of accounts built for your practice type, not a generic template.
- Bank & merchant reconciliationAccounts reconciled monthly, with merchant processing fees separated from revenue rather than netted into it.
- Deferred revenueMemberships, care packages, and pre-paid treatment series recognized as delivered, not as received.
- Provider compensationSalary, production, and hybrid comp tracked by provider so you can see margin where the decisions are made.
- Inventory & cost of goodsFor practices carrying real inventory — pharmacy, retail, injectables — COGS tracked properly so margin is real.
- Statement packageA closed P&L, balance sheet, and cash statement by a fixed date each month, formatted to be read.
Before we start
The cleanup.
Nearly every practice that comes to us needs one. We take your existing file apart and tell you exactly what's wrong with it — usually some combination of a chart of accounts inherited from a generic template, months of uncategorized transactions, deferred revenue that was never recorded, owner draws mixed with operating expense, and equipment financing booked as an expense instead of a capitalized asset.
The cleanup is quoted separately and up front, and it typically takes 30 to 60 days. We won't start CFO advisory on top of books we don't trust, and we'll tell you honestly if the fix is bigger than you expected.
Questions
Frequently asked.
What accounting software do you work in?
QuickBooks Online for the large majority of practices. We can work in QuickBooks Desktop or Xero where a practice is already established there, and we'll migrate you if the current setup is holding you back.
Do you work with our practice management system?
Yes. We integrate the accounting with your PM system so production, billing, and collections data reconciles to the books, rather than maintaining two systems that never agree.
Our books are a mess. Is that a problem?
It's the normal starting point. Most practices need 30 to 60 days of cleanup before the numbers can be trusted — uncategorized transactions, a chart of accounts inherited from a generic template, merchant fees booked as revenue, deferred revenue never recorded. We quote the cleanup separately and up front.
Do you handle payroll?
We work alongside your payroll provider and make sure provider compensation, clinical staff, and owner draws are recorded correctly and mapped to the right accounts. We don't run payroll ourselves.
When do the books close each month?
By a fixed date agreed at onboarding — typically the 15th of the following month. Same date every month, so you can plan around it.
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