Do I need an accountant, a bookkeeper, or both?
Most private practices end up working with both, and that catches people off guard when they assumed one person handled everything money related.
Here is the plain version of the split. A bookkeeper keeps your financial records accurate and current all year long. That means categorizing transactions, reconciling your bank and credit card accounts against the statements, matching deposits from your practice management system to what actually landed in the bank, tracking what you pay associates and contractors, and handing you monthly reports you can read in a few minutes between sessions.
A tax professional, usually a CPA or an enrolled agent, takes those records and prepares your returns. They also answer the questions that carry real dollars. Whether an S corporation election makes sense for your practice, how much to set aside for quarterly estimates, how your home office or mileage should be treated, and what the current rules and thresholds look like for the year you are filing. Those numbers and rules shift from year to year, so they should always come from the person who signs your return.
The two roles feed each other, which is the part people miss. A tax preparer can only work with what they are handed. When they get a year of uncategorized transactions, they either bill you for cleanup at their hourly rate or they estimate, and neither one leaves you better off. Clean, reconciled books make tax season cheaper and a lot calmer. Bookkeeping for mental health professionals is the year-round half of that pair, and it is the half Aretha handles.
Could you get by with just one for a while? Sometimes, yes. A brand new solo practice with a handful of clients, one business checking account, and no payroll can often manage its own records for a season and hire a tax preparer in the spring. The point where that stops working is usually predictable. You bring on your first associate, you add a second income stream like assessments or supervision, you fall a few months behind, or you start avoiding the bank app.
Aretha does not prepare tax returns. She keeps full-service bookkeeping current from $165 a month so your books are tax-ready and your tax preparer has everything they ask for without a scramble. If you already have someone doing your taxes, she works alongside them. If you do not have one yet, getting your books clean first makes that search a whole lot easier.
If you want to talk through which half of that pair your practice is missing, book a consultation with Aretha and she will tell you honestly.
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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.
More Questions
How do refunds and client credits get handled properly?
A refund reduces revenue in the period you give it back, and prepaid sessions sit as a liability until the session actually happens. Client credit balances need to be tracked by name so nobody's money quietly disappears into the books.
Read answerHow much should I set aside from each payment so taxes never surprise me?
Common guidance runs 25 to 30 percent of profit, and your tax preparer should confirm the right figure for your situation. The percentage applies to profit rather than to the full deposit, so knowing your real profit number is what makes the reserve accurate.
Read answerWhat's the difference between catch-up and clean-up bookkeeping?
Catch-up is for books that were never done, meaning months or years with nothing recorded. Clean-up is for books that exist but cannot be trusted because things are miscategorized, unreconciled, or duplicated. Both end the same way, with accurate current books and a monthly rhythm going forward.
Read answerHow do no-shows and late cancellations show up in my numbers?
Mostly they show up as an absence, which is why they are so easy to miss. Cancellation fees you actually charge should sit in their own income category so you can see what you recovered, and the cost of the empty slots shows up as the gap between what was scheduled and what was earned.
Read answerWhat's different about bookkeeping for a psychologist who does testing?
Testing behaves like a second business inside the same practice. The engagements run long, the money often arrives on a different schedule than the work, and materials cost real money, so testing revenue and testing costs belong in their own categories.
Read answerHow many sessions a week does my practice actually need?
Add your real overhead, the pay you want to take home, and the tax reserve your tax preparer sets, then divide by what you actually collect per session. Common benchmarks put a sustainable full caseload somewhere around 18 to 22 sessions a week. Clean books give you honest numbers to put into that math.
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