What kind of practice fits AD Keeps The Books best?
The short answer is a mental health practice with one to about ten people in it, located anywhere in the United States. I work remotely with clients coast to coast, so where your office sits matters a lot less than what kind of work happens inside it.
Within that, the range is wide. Therapists and counselors, psychologists doing testing and assessment alongside therapy, clinical social workers who just left agency work and are building business records for the first time, addiction and recovery counselors running individual and group sessions, psychiatric nurse practitioners managing medication visits, group practices with associates on payroll or on 1099, telehealth practices, and ABA providers with technicians in the field. Each of those has its own money rhythm, and I know what those rhythms look like on a bank statement.
Bookkeeping for mental health professionals is the only thing I do, and that came from somewhere. I was a licensed nurse for more than 15 years working in mental health before I ever opened QuickBooks. You will not spend our first call explaining what a superbill is, why private pay and insurance money land on different schedules, or what your EHR does. That part is already understood.
The owners who get the most out of working with me usually want the same handful of things. Books that are current rather than six months behind. Financials their tax preparer can actually use, so April is quiet. An honest view of what the practice earns and where the money goes. And one person who knows their practice, not a rotating team. When you email me, you get me. I do the work myself, which is why I keep the client list small enough to keep that promise.
It helps to be clear about what I do not do. I do not prepare tax returns. I keep your books tax-ready and hand off clean numbers, and questions about what you owe or how to plan belong with your tax professional. I run payroll for practices whose payroll system is already up and running, and I do not set payroll systems up. I also do not handle insurance billing, claims, credentialing, or coding, so if that is your main need, you want a billing specialist instead of me.
If your books are behind or messy, you are still a fit. That is where a lot of my clients start. Full-service bookkeeping starts at $165 a month, and pricing is worth confirming with me since scope varies by practice.
If any of this sounds like your practice, book a consultation and let’s talk it through.
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
What financial records should a private practice actually keep?
Business bank and card statements, revenue reports from your practice management system, receipts for deductible expenses, payroll and contractor records, and the bookkeeping file that ties them together. Keep them organized by year and month so any question has a findable answer.
Read answerHow should insurance payments show up in my books if you don't do billing?
I don't do insurance billing, claims, ERA posting, or credentialing. That work stays in your practice management system or with your biller. What bookkeeping does is reconcile what that process produces, matching every payer deposit that reaches your bank against what your records say you were paid.
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 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.
Read answerShould my associates be W-2 employees or 1099 contractors?
Classification is not really a preference you get to pick. It turns on how much control the practice has over the associate's work, and associates who see the practice's clients on the practice's schedule often land on the employee side of those tests. The call belongs with employment counsel and your tax professional, and I make sure the books and payroll records match whichever answer is true.
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.
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