Bookkeeping cleanup for medical & dental practices
Medical and dental practices have revenue flows nothing like a typical small business: insurance reimbursements net of contractual adjustments, patient copays through a card processor, and an S-corp owner who has to be on payroll. We set the books up right, or clean up the ones that weren’t.
Billed hourly against a written estimate, agreed before any work starts. Most cleanups are done in 2–6 weeks.
Why medical & dental practices books get messy.
Medical and dental practice books get complicated because the revenue almost never arrives the way it was billed. Insurance reimbursements land net of contractual adjustments, so the deposit rarely matches the charge, and EHR billing reports have to be tied back to actual bank activity for any of it to make sense. Patient copays flow through a card processor with its own fees. Most practices are structured as S-corps, which means the owner has to run a reasonable salary through payroll rather than just taking draws, a detail that’s easy to miss and expensive to fix later. Add financed equipment, clinical payroll, and the recordkeeping discipline a healthcare practice needs, and it’s clear why so many providers spend their first year untangling books that were set up generic from the start.
What trips up medical & dental practices.
Insurance reimbursements that never match the charge
Payers reimburse net of contractual adjustments, so deposits rarely equal what was billed. Without tying EHR reports to the bank, your revenue and your write-offs are both unclear.S-corp owner taking draws instead of a salary
Most practices elect S-corp status, which requires the owner on payroll at a reasonable salary. Draws instead of W-2 wages create a tax problem that compounds every year it’s missed.Patient payments and copays lost in processor fees
Copays and patient balances run through a card processor that nets out its fees. Booked as a single deposit, your patient revenue and merchant costs both vanish.Clinical payroll set up wrong from day one
Staff, providers, benefit deductions, and state registrations. Get the payroll foundation wrong and you spend the first year fixing it instead of seeing patients.Financed equipment booked as a plain expense
Imaging, chairs, and lab equipment bought on financing need to be capitalized with the loan recorded as a liability, not expensed, or the balance sheet misleads you and your lender.
What we handle for medical & dental practices.
Every cleanup is led by Elizabeth Olsen, a West Point graduate and QuickBooks Advanced Certified ProAdvisor, and built around how your industry actually earns and spends.
- Reconcile insurance reimbursements net of contractual adjustments and tie EHR billing reports back to bank deposits
- Separate patient copays and balances from insurance revenue and account for merchant processor fees correctly
- Set up or correct S-corp owner payroll alongside clinical staff, including state registrations and benefit deductions
- Capitalize financed equipment and record the related loans as liabilities with a clean amortization schedule
- Build a chart of accounts that makes year-end S-corp tax planning straightforward for your CPA
- Maintain the recordkeeping discipline a healthcare practice expects, with documented, reviewable monthly workflows
Medical & dental practices bookkeeping questions.
Cleaning up your medical & dental practices books starts with a free call.
Every engagement starts with a conversation and a clear scope and price in writing: billed hourly, no monthly bookkeeping retainer, no surprise invoices.