What do you deliberately not do?
There are four, and I name them early so nobody is surprised three months into working together. I spent more than 15 years as a licensed nurse, where scope of practice was something you knew cold and respected. I carry that same habit into this work.
I do not prepare tax returns. What I do is keep your books accurate and current all year so that when your tax preparer asks for the numbers, everything is ready and everything holds up. Questions about how much you owe, which entity makes sense, or how to plan for next year belong with your CPA or enrolled agent. I am glad to work alongside that person and hand over clean reports whenever they need them.
I do not handle insurance billing, claims, credentialing, or coding. That work stays inside your practice’s billing process, with your biller or your billing service, in the systems built for it. My part comes after. I reconcile what actually lands in your bank account against your books so you can see the money that arrived and what it cost you to earn it.
I do not set up payroll systems. If your payroll is already running in Gusto, QuickBooks Payroll, or something similar, I will process it every pay period so payday stops living in your head. Standing up a brand new payroll system is a different job with its own registrations and moving parts, and you deserve someone who does that work every day.
I do not give clinical or legal advice. I will never weigh in on caseload decisions, and I will not tell you whether an associate should be a W-2 employee or a 1099 contractor. That call belongs to your attorney or tax professional. Once you have the answer, my books record it correctly and your 1099s or payroll follow from there.
Everything inside those lines gets all of me. Private practice bookkeeping is the whole of what I do, and keeping it that narrow is on purpose. Full-service bookkeeping starting at $165 a month, catch-up and clean-up work when the books have fallen behind, bill payment, invoicing, payroll processing, 1099 preparation, and QuickBooks Online setup and training. You work with me directly, not with a rotating team.
If that sounds like the kind of help you have been looking for, book a consultation with me and tell me where your practice stands right now. If something you need falls outside my lines, I will say so plainly and point you toward the right person.
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.
More Questions
When can my practice afford to add another clinician?
You can afford an associate when the arithmetic works, meaning their pay, the extra overhead that comes with them, and several months of a partial caseload all fit inside what your practice actually collects. Your books supply those numbers, and the decision stays yours.
Read answerWhy don't my SimplePractice deposits match my session income?
Your platform pays out after processing fees come off the top, and it batches those payouts on the processor's schedule rather than one per session. That means the bank will never match your session ledger on its own. Good books record the gross revenue and the fees separately so both numbers are real.
Read answerWhat kind of practice fits AD Keeps The Books best?
Mental health practices with one to about ten people, anywhere in the country. Solo therapists, psychologists, LCSWs, addiction counselors, psychiatric nurse practitioners, group practices, telehealth practices, and ABA providers. If you want your books current and a bookkeeper who already speaks your language, you're the fit.
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.
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 does monthly bookkeeping actually do for a private practice?
Monthly bookkeeping keeps your books current, keeps your financials tax-ready, and gives you a clear view of how the practice is doing. Each month transactions get categorized, accounts get reconciled to the bank, and you get a short set of reports you can read between sessions.
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