Therapists & Counselors
Session revenue reconciled, practice expenses sorted, and a clear monthly picture of what your caseload actually earns. Bookkeeping from someone who spent more than 15 years in mental health care.
The Part Grad School Skipped
You trained for the clinical hour. Coursework, supervision, ethics, thousands of hours learning how to sit with people in their hardest moments. Somewhere in all of that, nobody taught you how to keep the books for a small business, and then you opened one. It shows up in small ways at first. A bank login you skip past. A drawer of receipts. A simple question about what you earned last month that you cannot answer without guessing.
Before I became a bookkeeper I spent more than fifteen years as a licensed nurse working in mental health. I know the terminology, I know what your days look like, and I know that after a full caseload there is almost nothing left over for spreadsheets. Falling behind on the money side is one of the most common things I see in this field. It says nothing about you as a clinician, and it can be fixed.
Who I Work With
Who I Work With
Licensed marriage and family therapists, licensed professional counselors, mental health counselors, and other therapists in private practice. Solo offices and small practices with up to about ten people. Private pay, insurance, or a mix of the two. My clients are all over the country, since this work happens by phone, email, and screen share.
Why It Gets Heavy
Why It Gets Heavy
Books that are behind gain a little weight every month. The longer it sits, the harder people tend to be on themselves about it, and that keeps them from opening the file at all. I have never once thought less of a client over the state of their records. Wherever you are is where we start.
How The Money Actually Moves
A therapy practice has a shape that generic bookkeeping tends to miss. Revenue arrives session by session. Your practice management or EHR system knows what was charged and what was collected, and your bank shows deposits that come through in batches, a few days later, often with processing fees already taken out. My job is to make those two agree every month so the income on your reports matches the work you actually did.
Private pay and insurance move on their own separate rhythms. A client card runs the day of the session and the money shows up that week. A payer remittance lands weeks later, covers a stack of visits at once, and rarely matches the full charged amount. Both belong in your books, recorded so you can tell them apart. Billing, claims, credentialing, and coding stay with you or with whoever handles that side for you. I pick the money up once it moves and make sure it is recorded correctly.
Deposits Matched To Sessions
Deposits Matched To Sessions
I reconcile what your system reports against what actually reached the bank, processing fees included. When a deposit comes in short or a payment never arrives at all, you hear about it in your monthly report instead of stumbling onto it a year later. That reconciliation work is the center of my Full-Service Bookkeeping.
Practice And Personal, Kept Apart
Practice And Personal, Kept Apart
Continuing education, licensure renewal, liability insurance, your EHR subscription, consultation group, office rent or the home office share, and the practice card that occasionally buys groceries. I sort all of it so your practice expenses stand on their own and your books stay tax-ready for whoever prepares your return.
Where Practices Get Stuck
The most common situation I see is books that were never started. Six months of transactions sitting in an account, two years, sometimes everything since the practice opened. Quarterly estimates get paid off a guess and April arrives with a held breath. That is what Catch-Up Bookkeeping is for. We work through it period by period until you are current, and then we keep it that way.
The other common one is income nobody can read. Processor deposits land as lump sums with no detail behind them. Personal transfers run through the same checking account. The profit and loss says one thing while the practice feels like something else, so decisions end up getting made on instinct. I talk to a lot of therapists who had been undercharging or working six days for longer than they realized, with no numbers around to tell them.
Guessing At What You Earn
Guessing At What You Earn
Without reconciled books, you find out what you made when your tax preparer tells you in the spring. That is a rough way to decide whether to raise your fee, take on another client, drop a day, or finally bring in help with the front desk.
Sliding Scale And Empty Slots
Sliding Scale And Empty Slots
Reduced fees are worth offering on purpose, with your eyes open. Same goes for the hours that empty out from late cancellations and no-shows. Clean books put a real monthly number on both, so you can decide how much of each your practice is able to carry.
What Changes When It Is Handled
Each month you get a short set of reports and a note from me, in plain language, about what they say. Money in, money out, what the practice kept. It is meant to be read in the gap between two sessions. If a line does not make sense to you, ask me and I will explain it without asking you to learn accounting.
Most people tell me the first thing they notice is the quiet. The bank login stops being something to avoid. Tax time becomes forwarding a file to your preparer. The money side stops taking up the part of your mind you need for your clients.
What A Week Of Sessions Really Earns
What A Week Of Sessions Really Earns
After processing fees, rent, software, insurance, and the rest of it, there is a real number underneath a full week of clinical hours. Once you can see that number, fee decisions and caseload decisions get much less abstract, and cutting back to four days becomes a question you can answer with math.
You Work With Me
You Work With Me
No account manager and no rotating team. You send me statements and access, I do the work myself, and you can reach me when something comes up. If your books are years behind, that is a normal starting point around here. Book a consultation, tell me where things stand, and we will sort out what getting current looks like for your practice.
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.
