What does monthly bookkeeping actually do for a private practice?
It does four things, and the practice owners I work with usually name all four before I do. It keeps the books up to date so nothing piles up in a drawer. It keeps the financials tax-ready, so April is a normal month rather than a scramble. It gives you clear visibility into the financial health of the practice. And it gives you a real view of profitability, meaning what your practice actually keeps once everything is paid.
Here is what the rhythm looks like. Every month, each transaction gets categorized. Session income that lands in the bank from your practice management system, the EHR subscription, liability insurance, rent or the home office setup, continuing education, licensing renewals, the small stuff that adds up. Then every bank account and credit card gets reconciled against the statement, so the numbers in QuickBooks match the numbers at the bank. If something is unclear, I send you a short list of questions instead of a long one. That is the core of full-service bookkeeping, and it is what makes everything else possible.
After that comes reporting. A profit and loss, a balance sheet, and a look at how this month compares to the months before it. I keep it short enough to read between sessions, and I am always available to walk through any line of it in plain language. No one needs to speak accounting to understand their own practice.
The reports are where the value shows up. You can see whether income really dipped in August or whether it only felt that way. You can see what your subscription stack costs you over a year. You can see whether adding an associate moved profit or just moved work around. Those are the decisions that shape a practice, and they go a lot better with real numbers behind them.
At tax time, your tax preparer receives clean, reconciled books and a full set of statements. I do not prepare returns, and questions about what you owe or how to plan for it belong with that professional. My part is making sure they never have to guess at what happened during the year.
Bookkeeping for therapists and other mental health practices starts at $165 per month with me, and you work with me directly the whole time. If you want to see what this would look like for your practice, book a consultation and we can talk it through.
Helping the People Who Help Others
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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.
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 answerWhy would a psychiatric nurse practitioner choose a bookkeeper who used to be a nurse?
The bookkeeping itself should be excellent no matter who you hire. What my 15 years as a licensed nurse in mental health changes is how much you have to explain before the work can start. I already know the tempo of a prescribing practice and the language you use.
Read answerWhat should I look at in my reports each month if I only have ten minutes?
Look at four things. Revenue compared to last month and the same month last year, the few expense lines that actually move, profit for the month, and cash on hand. That is enough to know whether the practice is healthy, and anything that looks strange can be a quick conversation.
Read answerWhat does the practice actually pay beyond an employee's wages?
The wage is only the starting number. Employer payroll taxes, unemployment insurance, workers compensation, and benefits all sit on top, which is why a 60 percent W-2 split and a 60 percent 1099 split are completely different economics for both sides.
Read answerWhat should an addiction counseling practice's books account for?
Separate income by the kind of work behind it, since individual sessions, groups, assessments, and education programs earn very differently for the time and space they use. Your books also need a consistent way to record sliding scale fees, payment plans, and partial payments, plus clear tracking of group revenue and unpaid balances.
Read answerWhat does it actually cost to run a therapy practice?
Established solo practices commonly run somewhere between $1,500 and $5,000 a month in overhead, and lean virtual practices often come in well under that. Those figures move around and are worth verifying. The number that matters most is your own, and your books can tell you exactly what it is.
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