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 quarterly estimated taxes fit into my bookkeeping?
Your tax preparer calculates the amounts. Your books supply the current profit number those calculations depend on, and they keep the record of what you paid and when. When the books are months behind, every estimate turns into a guess.
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 tax-ready books mean if you don't do taxes?
Tax-ready means the books are complete, categorized, reconciled, and documented before your tax preparer ever opens the file. I keep the records right all year so your preparer does the tax work quickly and with very few questions.
Read answerI've been running my practice through my personal checking account. How do I untangle it?
This is the most common thing practice owners tell me, and it is completely fixable. The fix has two parts, opening dedicated business accounts for everything going forward, and sorting the historical mix so the practice's real activity gets recorded properly.
Read answerI'm a good therapist and my books are a disaster. How normal is that?
It is extremely normal. Clinicians spend years training for the work in the room and almost no time learning bookkeeping, so the money side is usually the part that slips. Catch-up work has a clear beginning and a clear end, and it says nothing about your skill as a clinician.
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