Health practices
Bookkeeping for private medical practices
Your practice system knows what was billed. Your bank knows what arrived. Your books need to agree with both.
Updated October 4, 2026
In short
Small private practices get paid by insurance remittances, patient card payments and sometimes membership fees, all landing in batches. We match those deposits to your practice system's reports, record provider and staff pay, and track equipment loans and leases, working from totals and reports rather than patient records wherever possible. Most practices sit in Complex.
How the money moves
How money comes in and goes out
Money arrives as insurance payments, often by ACH with a remittance file, patient copays and balances through the front-desk card terminal or patient portal, and for some practices, monthly membership fees.
The detail of who paid for which visit lives in your practice management or billing system, not your books. The books record the deposits, then tie them back to your system's daily or monthly deposit reports.
Common problems
Where the books usually go wrong
Batch deposits
One insurance deposit can cover dozens of claims. Matching it to the practice system's report is the only way to know nothing went missing.
Write-offs and adjustments
Contractual adjustments live in the billing system. The books should reflect what you actually collect, not what you charged.
Provider compensation
Associate pay tied to collections or production needs clean, timely numbers to calculate.
Equipment and leases
Exam equipment, imaging and build-outs often come with loans or leases that need proper tracking.
Every month
What we do every month
- Match insurance and patient deposits to your practice system's deposit reports
- Reconcile the merchant account and bank accounts to their statements
- Record payroll from your provider, split by role if you want it
- Track equipment loans, leases and their interest
- Send monthly statements with collections and overhead clearly shown
A month of books, for example
A two-physician family practice deposits from four insurers and a card terminal. Each month we'd match roughly sixty deposits to the billing system's deposit report, flag two remittances that never arrived, and record payroll and the ultrasound lease. Their overhead as a share of collections is on one line of the monthly report.
Illustrative example, not a client story.
Getting started
What we need from you
- Deposit or payment reports from your practice management or billing system
- Access to your bookkeeping software, bank and merchant accounts
- Loan and lease statements for equipment
Software and statements we work from
- athenahealth
- eClinicalWorks
- Kareo / Tebra
- AdvancedMD
- Square or Stripe terminals
- Gusto
- ADP
- QuickBooks Online
Price
What it costs
Most practices fit the Complex tier, $600 to $800 a month and up, depending on providers, locations and payer mix. Small cash-pay or membership practices can sit in Moderate.
One flat monthly price, set after the free review. See the pricing guide or estimate your tier.
Questions
Common questions
Will you see patient information?
We work from deposit totals and summary reports wherever possible. If a task does require patient-level detail, we'll discuss in the review whether a business associate agreement is needed before we start.
Do you do medical billing or claims?
No. Billing and claims stay with your biller or your system. We keep the business's books and reconcile what was collected.
Can you handle more than one location?
Yes. Locations can be tracked as classes so each one has its own numbers.
Do you calculate provider bonuses?
We provide the collections and expense numbers they're based on. The formula itself belongs to your agreement with the provider.
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