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Physician Bookkeeping

Bookkeeping for Doctors
Who'd Rather Practice Medicine

You spent a decade learning to save lives — not categorize expenses. We handle the financial back-office so you can focus on patients.

Book Your Strategy Session
I
The Problem

Why Physicians Need Specialized Bookkeeping

Medical practices operate on a fundamentally different financial model than typical small businesses. Your revenue doesn't arrive in simple transactions — it flows through a labyrinth of insurance payers, contractual adjustments, patient copays, and write-offs. Most bookkeepers have never seen an ERA, don't know what a contractual adjustment is, and have no idea how to reconcile aged A/R against EOBs.
Then there's the income complexity. A physician might earn a W-2 salary from a hospital, 1099 income from locum tenens shifts, distributions from a practice they co-own, rental income from investment properties, and consulting fees from expert witness work — all in the same year. Standard bookkeeping software wasn't designed for this. Standard bookkeepers weren't trained for this.

"Most bookkeepers don't understand physician compensation structures, K-1 distributions, or how to classify CME travel."

— We Do
01

Complex Revenue Cycles

Insurance collections, contractual adjustments, write-offs, aged A/R — most bookkeepers misclassify these entirely.

02

Multiple Income Streams

W-2, 1099, distributions, rental income, consulting — consolidated, not siloed across different systems.

03

Equipment Depreciation

Medical equipment, imaging systems, vehicles — proper capitalization saves thousands in taxes each year.

04

Overhead Benchmarking

Staff, rent, malpractice, supplies — measured against industry standards so you know exactly where you stand.

05

Compensation Structures

K-1 distributions, S-Corp reasonable salary, CME travel — details standard bookkeepers consistently miss.

06

Multi-Entity Structures

Practice + real estate LLC + holding company — separate books that tie together seamlessly at tax time.

II
Our Services

What We Handle for Medical Practices

Monthly reconciliation, analysis, and reporting tailored to how physicians actually run their practices.

Revenue Cycle Tracking

Collections by payer type, contractual adjustments, write-offs, and aged A/R. Real-time visibility into cash flow.

Provider Compensation

Track physician salaries, distributions, K-1 allocations, and side income. Know exactly what each partner earns.

Equipment Depreciation

Proper cost capitalization and depreciation schedules for diagnostic equipment, surgery suites, and systems.

Overhead Monitoring

Overhead as percentage of revenue, benchmarked against industry standards. Identify cost control opportunities monthly.

Staff Payroll

Payroll processing, benefits tracking, and W-2/1099 management for physicians and clinical staff.

Multi-Entity Accounting

Practice + real estate LLC + personal holding company. One clear, consolidated financial picture.

III
Multi-Income

Physicians With Side Income

You're not just running a practice. Many physicians have rental properties, locum tenens assignments, consulting work, or other business ventures. These income streams create complexity that standard bookkeeping systems weren't designed to handle. We consolidate all of your income into one clean picture — making tax planning simpler, entity optimization clearer, and year-end filing stress-free.
W-2 salary + 1099 locum tenens
Rental property income & depreciation
Consulting or expert witness work
Side medical businesses & ventures
Physician Tax Hub Locum Tenens Guide
Sample Report

Monthly P&L Consolidation

W-2 Salary (Primary)$180,000
1099 Locum Work$45,000
Rental Property$8,500
Total Income$233,500

One unified picture. One P&L. No guessing about your true profitability across all income sources.

IV
CPA-Led

The CPA Advantage for Doctors

Bookkeepers reconcile. CPAs optimize. We do both — and then we use your clean, monthly data to plan your taxes proactively rather than scrambling at year-end.

S-Corp Optimization Solo 401(k) Planning

Monthly P&L with Ratios

Clean P&L by the 15th, with overhead ratio analysis. Know your percentage of revenue going to staff, rent, and malpractice.

Quarterly Tax Projections

We project your year-end tax liability quarterly so you can make informed estimated tax payments.

Entity Optimization

Should you be an S-Corp? A multi-member LLC? We review your structure annually and model savings.

Retirement Planning

Solo 401(k), defined benefit plans, profit sharing — we track contributions and maximize your shelter.

V
Questions

Frequently Asked Questions

Yes. We work with solo practitioners, multi-specialty groups, and W-2 employed physicians with side income. If you have a practice or multiple income streams, we can handle it. Many employed physicians have rental properties or consulting income — we consolidate everything into one clear picture.

That's exactly our specialty. We track all income sources — W-2 salary, 1099 locum tenens, practice distributions, rental properties, consulting work — and create a consolidated monthly P&L. This visibility makes tax planning and entity optimization decisions much easier.

Absolutely. We are a full-service CPA firm. Your monthly bookkeeping feeds directly into your tax returns (1120-S, 1065, 1040), so there is no disconnect between your accounting and your tax filing. We handle entity structure, estimated taxes, and year-end planning.

We categorize collections by payer type, track contractual adjustments, and reconcile against ERA (electronic remittance advice) and EOBs. Many practices struggle with aged A/R and denials — we flag these so your billing team can follow up and your overhead ratio reflects true reality.

We start with a 30-minute strategy call to understand your practice structure, current systems, and pain points. Then we handle the migration to QuickBooks Online (if needed), set up your chart of accounts for medical practice specifics, and begin monthly reconciliation and reporting. The full onboarding takes 2-4 weeks.

Our pricing is fixed-fee and transparent, starting at $500/month for solo practices with straightforward income and scaling to $1,500–$3,000+ for multi-entity groups with complex revenue cycles. We quote based on transaction volume, practice complexity, and number of entities.

VI
Related Reading

Outsourced Bookkeeping

Complete bookkeeping solution. Monthly reconciliation, reporting, and tax preparation.

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Monthly Accounting

Proactive monthly accounting with financial statements and strategic insights.

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Physician Tax Planning

S-Corp optimization, entity structuring, estimated taxes, and deduction planning.

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Focus on Patients.
We'll Handle the Books.

Stop worrying about revenue cycles, provider compensation, and overhead ratios. Let us manage your practice bookkeeping so you can focus on what you do best.

Schedule Your Strategy Session