Bookkeeping for San Francisco Mental Health Practices
Monthly bookkeeping, payroll, and catch-up work for San Francisco therapists, psychologists, and group practices. You work directly with Aretha.
Bookkeeping for San Francisco Practices
San Francisco has an unusual concentration of mental health clinicians, and in this city private practice is often the plan from the very beginning. Graduate programs, supervision networks, and consultation groups all point that way. The result is a city full of small practices run by people who trained for clinical work and ended up owning a business at the same time. I’m Aretha, and bookkeeping for therapists and other mental health professionals is the only work I do.
Practicing here also costs more than practicing almost anywhere else. Office hours in a shared suite, your EHR subscription, liability insurance, consultation fees, parking, and a dozen small charges that never announce themselves. A good fee schedule can still turn into a thin month when nobody is watching what goes out the door. I keep your numbers current so you always know what the practice is actually earning. I work from Lancaster in the high desert, everything happens remotely, and you work with me rather than a rotating team.
Monthly Bookkeeping
Monthly Bookkeeping
Full-service bookkeeping starting at $165 a month. Transactions categorized, bank and credit card accounts reconciled, and monthly reports short enough to read between sessions. If anything on them puzzles you, call me and I’ll walk you through it in plain language.
Catch-Up and Clean-Up
Catch-Up and Clean-Up
If the books were never started, I build them from your statements and bring every month current. If they exist and nobody trusts them, I find the miscategorized entries and unreconciled accounts and fix them properly. Falling behind happens to good clinicians all the time.
Payroll and 1099s
Payroll and 1099s
If your practice already has payroll set up, I run it every pay period so your associates and admin staff are paid right and on time. I don’t do payroll system setup, and I say that upfront. At year end I prepare 1099s for contract clinicians, supervisors, and vendors.
Tax-Ready Books
Tax-Ready Books
I don’t prepare returns. What I do is hand your tax preparer books that are reconciled, categorized, and backed up with documentation. Filing season turns into a handoff instead of three weekends of receipt archaeology.
San Francisco Practices I Work With
No two practices in this city look the same. A solo LMFT with an office off 24th Street and a waitlist. A psychologist juggling neuropsych assessments, therapy hours, and consulting work at three different rates. A group practice downtown with six associates and an office manager. A psychiatric nurse practitioner seeing medication management visits back to back all day. The clinical work is different in every case, and the need for honest numbers is the same.
Most of these practices run between one and ten people. At that size the money side matters a great deal, and hiring an in-house bookkeeper still makes no sense. That’s the gap I fill. If your books have been sitting on the back burner while you carry a full caseload, book a consultation and we’ll talk about where things stand.
Solo Therapists and Counselors
Solo Therapists and Counselors
You’re the clinician, the scheduler, the marketer, and the bookkeeper. I take that last job off your list. Session income reconciled, business spending separated from personal, and a monthly picture of what a full week of clinical hours really brings home.
Group Practices With Associates
Group Practices With Associates
San Francisco has a lot of group practices with associate clinicians. Splits and salaries recorded correctly, W-2 staff and 1099 contractors each tracked properly, and reporting that shows what each clinician contributes so you know whether the next hire helps.
Telehealth and Hybrid Practices
Telehealth and Hybrid Practices
Plenty of practices here see clients over video across the Bay and up and down California, sometimes with a day or two in an office. Platform payouts, merchant processing fees, and the subscription stack all get reconciled so the real cost of running online is visible.
Prescribers and Assessment Practices
Prescribers and Assessment Practices
I spent more than 15 years as a licensed nurse in mental health before I opened QuickBooks for anyone. Psychiatric nurse practitioners, psychiatrists, and testing psychologists don’t have to explain their day to me. High visit volume, longer assessment engagements, and mixed revenue all get recorded in a way that reflects how the practice truly runs.
Questions About This Area
You're in Lancaster. Can you really keep the books for a practice in San Francisco?
Yes. All of my client work happens remotely, and I work with practices across the country. We share documents securely, talk by phone or video when you want to, and you hear from me directly every time. Being in the same state is a nice bonus for California practices, and it isn't what makes the work good.
What does this cost?
Full-service monthly bookkeeping starts at $165 a month. Payroll starts at $150 a month for practices that already have a payroll system running. Catch-up and clean-up work is quoted per engagement after I see what exists. I'll give you a real number before you commit to anything.
My money comes in from private pay, a couple of insurance panels, and a platform. Can you sort that out?
That's very common in San Francisco, and yes. I reconcile the deposits that actually land in your bank account against your practice records so you can see what each part of the practice brings in. I don't do insurance billing, claims, credentialing, or coding, so if you have a biller or a billing service, I work alongside them.
Do you file my taxes?
No. I don't prepare tax returns. I keep your books clean, reconciled, and organized so your tax preparer has everything they need without a scramble in March. If you don't have a preparer yet, tidy books make finding one much easier.
I haven't touched my books in over a year. Is that too far gone?
It isn't. That's how a lot of my clients arrive. We start with catch-up work to get every month recorded and reconciled, and then move into steady monthly service so it doesn't pile up again. There's no lecture from me about how it got this way.
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.
