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.
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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
What software should a small practice run its money on?
Three pieces cover almost every small practice. The practice management platform you already use for scheduling and client payments, QuickBooks Online for the actual books, and a business bank account underneath both, connected so the deposits reconcile.
Read answerWhat does my software stack really cost me per month?
Most practices are surprised by the total once every subscription is added up, since EHR tiers, telehealth add-ons, scheduling tools, directory listings, and card processing fees all arrive separately. Coding them to one category in your books gives you a single number you can review and prune once a year.
Read answerHow do you keep my financial information secure?
I only need financial records, never clinical ones. Documents move through secure file sharing rather than email, I work in QuickBooks Online under my own user login, and I use read-only bank connections instead of shared passwords wherever the bank supports it.
Read answerWhat has to happen before January so contractor 1099s are easy?
Almost everything. Collect a W-9 from every contractor before the first payment, record payments by payee all year long, and review the totals in December. Do that and January is nothing more than paperwork.
Read answerMy practice is brand new. When should bookkeeping start?
At the beginning, ideally before your first client payment arrives. A practice that opens with a separate business account, a proper QuickBooks setup, and a monthly rhythm never needs a cleanup later, and starting right costs far less than untangling a year of mixed records.
Read answerI offer sliding scale to a good share of my caseload. What should my books show me about it?
Your books should show your effective rate per session, the gap between your posted fee and what you actually collect, and how much of your weekly caseload sits at a reduced rate. Those three numbers tell you what sliding scale really costs and how much of it your practice can carry.
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