Bookkeeping for contractors and service businesses in MetroWest and Greater Boston.

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Medical & Dental Practices

What you produce and what you collect are different numbers. We track both, manage your AR aging, and give you financials that reflect reality instead of what the schedule looked like.

The Industry

Your practice management software says you produced $85,000 last month. Your bank account shows $64,000 in deposits. That $21,000 gap includes insurance adjustments, claims still in process, and patient balances that may or may not get paid. Without tracking each piece separately, you’re making decisions based on a number that doesn’t reflect what actually happened.

Medical and dental practices run on high fixed costs. Rent, equipment payments, clinical staff salaries, and insurance all hit whether you saw 20 patients that day or 12. Your break-even is real and predictable. What’s less predictable is when collections actually arrive. A procedure performed today might not deposit for 45 days after insurance processing, and the patient portion might take another 60 days or never come at all.

Who This Covers

Dental practices, chiropractic offices, optometry clinics, physical therapy practices, and similar healthcare providers across MetroWest and Greater Boston. Anyone billing insurance while also collecting patient payments directly.

What Complicates It

Multiple insurance payers with different fee schedules and adjustment rates. Claims that sit for weeks before payment. Patient portions that require follow-up. Equipment financing with depreciation implications. Clinical staff payroll with varying schedules. All of this happening while you’re trying to focus on patient care.

What We Handle

We separate production from collection in your books so you can see what’s real. Insurance payments get reconciled to claims submitted. Adjustments and write-offs are categorized properly instead of lumped together. Patient AR gets tracked and aged so outstanding balances don’t disappear into the pile. You know what’s been collected, what’s pending, and what needs attention.

Payroll for your clinical team runs on schedule without eating your administrative time. Hygienists, dental assistants, front desk staff, therapists. Tax withholdings and deposits handled correctly. Equipment depreciation tracked for tax purposes. Supply costs and lab fees recorded consistently. Monthly financials show you what actually happened with collections and expenses, not just what the appointment book looked like.

Insurance and Patient AR

We track receivables from insurance carriers and patients separately. Aging reports identify which claims are sitting too long and which patient balances need follow-up. You see what’s coming, what’s overdue, and what’s stuck. The data supports your billing staff in prioritizing collection efforts where they’ll actually work.

Payroll and Overhead

Clinical and administrative staff paid accurately and on time. Benefits, withholdings, and tax deposits handled. Equipment payments and depreciation tracked to support tax planning. Rent, supplies, and lab costs recorded consistently. Monthly reports that show your true overhead rate relative to collections so you can see where the money goes.

Common Problems

Most practices only look at production reports. That number includes insurance adjustments that will never be collected and patient portions that might take months to receive if they come at all. A practice producing $90,000 monthly might only collect $68,000. Without separating these figures, you can’t tell if you’re profitable or just busy. You renew leases and give raises based on production that never turned into cash.

Patient balances are the quiet leak. Insurance pays their portion and moves on. The remaining $75 patient responsibility sits on a statement that gets mailed twice and then forgotten. Multiply that by 40 or 50 patients per month and you have thousands of dollars slipping away annually. It’s not dramatic enough to notice in any single week, but it adds up to a real problem over the year.

Collection Rate Confusion

You billed $82,000 but deposited $61,000. Is the $21,000 difference timing, adjustments, or money that will never come? Without proper categorization, you can’t answer the question. You can’t tell if your collection rate is declining or if insurance processing is just slower this month. The data exists but isn’t organized to be useful.

Equipment and Tax Timing

That new chair, X-ray machine, or laser represents both a cash flow decision and a tax decision. Section 179 depreciation matters, but so does timing equipment purchases relative to your income level. Without planning during the year, you either miss deductions or take them at the wrong time. Tax prep in April is too late to fix it.

What Changes

You see what’s actually happening with your money. Production, adjustments, and collections tracked as separate figures that tell a complete story. Aging reports on insurance claims and patient balances that prompt follow-up before accounts go stale. The gap between what you bill and what you deposit becomes visible and manageable instead of a mystery you notice only when cash gets tight.

Monthly financials arrive on schedule with a summary that explains what changed and why. You know your overhead rate, your collection rate by payer, and which parts of the business are performing well. Tax prep is handled by someone familiar with medical practice depreciation and equipment deductions. Equipment decisions get made with actual cash flow projections, not optimistic guesses.

Visibility into True Performance

Collection rate tracked over time by insurance payer. Patient AR aging that identifies problems early. Overhead as a percentage of actual collections, not production. Numbers that reflect how the practice is really doing. Decisions based on cash reality instead of the schedule’s promise.

Planning with Confidence

Equipment purchases evaluated against real cash flow. Quarterly tax estimates that account for the timing lag between production and collection. Compensation analysis for adding an associate or expanding hours. Financial clarity that supports growth decisions instead of forcing you to guess and hope it works out.

Greater Boston's Trusted Bookkeeping Partner

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Full-service bookkeeping firm serving contractors and small businesses in MetroWest and Greater Boston. From monthly bookkeeping to job costing and payroll, we bring 20 years of hands-on business experience to your back office. Locally owned in Bellingham, Massachusetts.

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