Bookkeeping for Madison Mental Health Practices
Bookkeeping for therapists, psychologists, and group practices in Madison. Books kept current, clear, and ready for your tax preparer.
Bookkeeping for Madison Mental Health Practices
Madison has real depth in mental health care for a city its size. The university trains clinicians and a good number of them stay and build practices here. You find them in remodeled houses off Monroe Street, in offices out past Hilldale, in suites in Fitchburg and Middleton, and in home offices where someone sees clients three or four days a week. Most of these practices are small, somewhere between one clinician and a team of ten, and most of the business side lands on the owner’s desk.
I’m Aretha Dirden. I keep the books for practices like these all over the country from my office in Lancaster, California. Before this I spent more than 15 years as a licensed nurse working in mental health, so the world you work in is already familiar to me. Private practice bookkeeping is the only kind of bookkeeping I do, and you work with me directly instead of a rotating team.
Monthly Bookkeeping
Monthly Bookkeeping
Every month I categorize your transactions, reconcile your bank and credit card accounts, and send reports you can read in the gap between sessions. Full-service bookkeeping starts at $165 a month and keeps the books current instead of letting a year pile up.
Catch-Up and Clean-Up
Catch-Up and Clean-Up
Six months behind or three years behind, both are fixable. If the books exist and the numbers feel unreliable, that’s a clean-up. I sort through the history, reconcile everything, and hand back records you can believe.
Payroll and 1099s
Payroll and 1099s
For practices whose payroll system is already up and running, I process every pay period so nobody has to carry payday around in their head. I also prepare year-end 1099s for associate clinicians, contract supervisors, and vendors.
Tax-Ready Books
Tax-Ready Books
The return itself belongs with your tax preparer. My job is making sure the numbers they receive in January are complete, reconciled, and sorted into categories that make sense for a practice, so nobody has to reconstruct the year in a hurry.
Madison Practices I Work With
The practices I work with in Madison cover most of the field. Therapists and counselors seeing individuals and couples, psychologists mixing testing and assessment with their therapy hours, clinical social workers who left agency work to build something of their own, addiction and recovery counselors, psychiatric nurse practitioners handling medication management, and group practices bringing on associates who are still working toward full licensure.
What they share is a small operation with real money moving through it and an owner who would rather not spend Sunday night in QuickBooks. If that sounds like your practice, book a consultation with me and tell me where things stand. I’ll be honest with you about what needs doing, what it costs, and how long it takes.
Therapists and Counselors
Therapists and Counselors
Plenty of your clients work for the state, the university, or one of the large employers out toward Verona, so insurance payments and private pay both flow in on their own schedules. I reconcile what your practice system reports against what actually reached the bank, and show sliding scale and no-show patterns in the monthly numbers.
Psychologists and Assessment Work
Psychologists and Assessment Work
Testing engagements pay differently than a standing weekly hour, and report writing eats time that never shows up on a schedule. I track assessment, therapy, consulting, and evaluation revenue separately so you can see which part of a mixed practice is carrying the rest.
Group Practices
Group Practices
Associates on fee splits or salary, W-2 staff, contractors on 1099s. I record compensation correctly, run payroll for practices whose system is already set up, and report in a way that shows margin by clinician so you know whether the next hire actually helps.
Telehealth Practices
Telehealth Practices
Madison clinicians reach clients across rural Wisconsin by video, and the subscription stack behind that adds up quietly. Platform and EHR fees, processor fees, payouts matched to sessions, home office records kept clean for your tax preparer.
Questions About This Area
You're in California. How does that work for a practice in Madison?
The same way it works for practices in every other state. Everything I need reaches me digitally, and we talk by phone or video whenever you want. Madison runs two hours ahead of me, so when your last session ends at six, it's four in the afternoon here and I'm still at my desk.
My caseload swings with the university calendar. Will that show up in the books?
Yes, and that's a good thing. Practices that see students, grad students, and university staff often have a packed September and a quiet June. Monthly reports make that pattern visible so you know how much the busy stretch needs to carry the slow one. Seasonality stops being stressful once you can see it on paper.
What does it cost?
Full-service monthly bookkeeping starts at $165 a month. Payroll starts at $150 a month for practices whose payroll system is already running. Catch-up and clean-up work is quoted per engagement after I look at what exists. You'll have the number before any work begins.
My books haven't been touched in over a year. Where do we start?
That's how a lot of practices come to me. If the books were never done, that's catch-up work. If they were done and the numbers look wrong, that's clean-up. Either way I work back through the statements period by period, reconcile the accounts, and get you current. There's no lecture about how it happened.
Do you prepare tax returns or handle insurance billing?
No to both. I don't prepare returns, and I don't do insurance billing, claims, credentialing, or coding. Your biller or your practice system handles the claims side. I keep your books accurate, reconcile the deposits that actually reach your bank, and hand your tax preparer numbers they can work with.
Helping the People Who Help Others
Let's Start With
a Short Conversation
Tell me where your books stand right now, even if the honest answer is that nobody has looked at them in a year. I'll ask a few questions and give you a clear idea of how I can help.
Other Areas
