Bookkeeping for Medical & Dental Practices

Practice books break at the deposit line: insurance remits a net amount covering many patients across several claims, after adjustments and takebacks. Recording the deposit without the detail makes collections impossible to analyze.

We handle your practice’s financial records only — never patient health information.

Deposits explained

Insurance remittances reconciled against what was actually billed.

Processing fees visible

Merchant and payment fees tracked instead of netted away.

Draws separated

Owner draws kept distinct from practice expense.

Financial records only

We handle the practice books and never touch patient health information.

What we handle

Recording and categorizing insurance and patient deposits, reconciled monthly
Merchant and payment-processing fee tracking
Payroll journal entries for providers and staff
Equipment, lease, and financing tracking
Separating owner draws from practice expenses

Common problems we fix

Deposits that do not match what was actually collected
Personal and practice spending mixed together
Books behind and stressful at year end

Why your state matters here

Bookkeeping for medical and dental practices is not the same in every state. Sales tax rates and what is taxable, registration and licensing, payroll rules, and filing cadence all vary — and for this industry those differences change real work, not just a number on a form. Pick your state below for specifics.

Trades and specialisms we cover

Medical & Dental Practices is a broad category, and the bookkeeping differs meaningfully between the trades inside it. Here is what actually changes, trade by trade — each is handled under this service rather than as a separate engagement.

Dental Practices — jump to this section

Dental books have to separate the practice from the lab bill and the supply bill, both of which are large, variable, and directly tied to production — a practice whose lab cost is drifting upward as a percentage of production has a pricing or a case-mix problem, and it is only visible when lab is its own account. Associate compensation is frequently production-based, which means it is calculated from figures the books must be able to support. Membership plans sold direct to patients are prepaid revenue delivered across a year.

Chiropractic Practices — jump to this section

Chiropractic runs heavily on prepaid care plans — a patient pays for a course of treatment in advance, and that money is earned as visits are delivered, not when the card is charged. Practices that recognise it on collection show a strong month whenever they sell a plan and a weak one whenever they deliver it. Personal injury and attorney-lien cases are a separate receivable class that can age for a year or more and needs tracking apart from ordinary insurance balances.

Physical Therapy Practices — jump to this section

Physical therapy bills by unit and by code against payer contracts with different allowed amounts, so revenue recorded at billed rates will always be wrong and the contractual adjustment is the difference. Authorisation limits mean a visit delivered beyond an approved number may never be paid, which is a write-off that should be visible rather than absorbed. Cash-pay and wellness services sit alongside insurance work with an entirely different collection profile.

Optometry Practices — jump to this section

Optometry is a clinical practice and an optical retailer sharing one location, and the two have different margins, different tax treatment on the retail side, and different inventory needs — frames and contact lenses are stock that has to be counted. Vision plan reimbursement works differently from medical insurance and frequently covers the exam and the materials under separate arrangements, which means one patient visit can generate two receivables from two sources.

Dermatology and Aesthetics — jump to this section

A practice combining medical dermatology with elective aesthetic work is running insurance-billed and cash-pay businesses side by side, and blending them hides that one funds the other. Injectables and devices are high-value inventory consumed per treatment, with lot tracking and expiry that matter. Packages and memberships sold up front are deferred revenue delivered across months, and retail skincare is a third revenue stream with its own tax treatment.

Urgent Care Clinics — jump to this section

Urgent care sees high patient volume with a large proportion of self-pay and high-deductible patients, which makes point-of-service collection and the resulting small-balance receivable a defining feature. Occupational health contracts with local employers are a different revenue stream billed on terms rather than at the visit. Staffing flexes with volume, so labour cost per visit is the operating metric the books need to support.

DME Suppliers — jump to this section

Durable medical equipment combines inventory with insurance billing and, for rented items, revenue that accrues monthly for as long as the patient has the equipment — which means an asset on your books in someone else’s home. Rental and purchase revenue behave completely differently and must be separated. Documentation requirements are strict enough that a claim denied for paperwork is a common and entirely avoidable loss, and tracking denials by reason is how a practice finds it.

Not listed? Tell us what you do — these are the ones we are asked about most, not the limit of what we handle.

We keep the books. You run the business.

Categorization, reconciliation, month-end close, and clean financial statements — with nothing left for you to chase.

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How It Works

Free review

We look at how your medical and dental practices books are set up today.

Fix the structure

Chart of accounts rebuilt around how your industry actually earns and spends.

Catch up

Anything behind gets cleaned up at a fixed quoted price.

Close monthly

Current, reconciled books every month — ready for your CPA.

Medical & Dental Practices Bookkeeping by State

Sales tax nexus and taxability, licensing, payroll rules, and filing cadence differ by state. Pick yours for a state-specific guide.

Medical & Dental Practices — Frequently Asked Questions

Do you understand medical and dental practices specifically?

Yes — that is the point of setting the books up by industry. Practice books break at the deposit line: insurance remits a net amount covering many patients across several claims, after adjustments and takebacks. Recording the deposit without the detail makes collections impossible to analyze.

What does bookkeeping for medical and dental practices actually involve?

Recording and categorizing insurance and patient deposits, reconciled monthly; Merchant and payment-processing fee tracking; Payroll journal entries for providers and staff; and 2 other recurring pieces. It is done monthly rather than reconstructed at year end, so the numbers are usable while the decisions are still open.

What usually goes wrong in medical and dental practices books?

The three we see most: deposits that do not match what was actually collected; personal and practice spending mixed together; books behind and stressful at year end. Insurance deposits rarely match what you billed. The books have to explain the gap.

Do you work with dental practices, chiropractic practices, physical therapy practices?

Yes — those are three of the 7 trades covered under this service, and each is listed on this page with what changes about its books. They are handled under one engagement rather than quoted separately.

Do you work in the accounting file my medical and dental practices business already uses?

Yes. We work inside your file so you keep ownership and full visibility. If you do not have one set up yet, we build it around your industry from the start, including a chart of accounts that matches how you actually earn.

Can you clean up medical and dental practices books that are months behind?

That is our specialty. Cleanup is quoted at a fixed price after a short no-obligation review, so you know the cost before any work begins. Scope varies enormously, so we look first and quote second.

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Bookkeeping built for medical and dental practices

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