Services Built for Independent Practices
Everything is designed around the operational reality of running a 1-5 provider health practice. No generic advice. No junior staff.
Financial Oversight
Monthly review of your books with a standard KPI pack. Same format every month so you can track trends, spot issues early, and make decisions with actual numbers.
- Monthly P&L and Balance Sheet review
- Collections tracking and reimbursement monitoring
- Payroll percentage and overhead percentage analysis
- Cash flow monitoring with reserve recommendations
- Owner compensation snapshot and distribution guidance
- Variance explanations when numbers shift
What this looks like in practice
You get a consistent monthly report that answers the questions you actually care about: Am I profitable? Where's the cash going? Can I take a distribution? Is payroll too high?
No 40-page report you'll never read. A clear, operator-level snapshot with the 10 numbers that matter for your practice.
Tax Strategy
Proactive tax planning means you know what's coming before it arrives. Quarterly projections, strategic moves identified early, and implementation tracked through the year.
- Comprehensive tax strategy assessment
- Quarterly tax projections and estimated payments
- S-Corp reasonable compensation optimization
- Retirement plan analysis (Solo 401(k), Safe Harbor 401(k), Cash Balance Plans)
- Section 179 and equipment purchase analysis
- Entity structure review and optimization
- Year-end planning with implementation checklist
Real example: Safe Harbor 401(k)
A solo dermatology practice was limited by a basic 401(k). After implementing a Safe Harbor plan, the owner unlocked $20-40k+ more per year in tax-advantaged retirement savings — reducing current taxes while building long-term wealth.
That's the kind of opportunity that surfaces through proactive planning, not at tax time.
Owner Advisory
Regular planning calls focused on the decisions in front of you. When you have a question about your business, you have someone to call who understands practice economics.
- Monthly or quarterly strategy calls
- Decision support backed by your actual numbers
- Hiring analysis and provider compensation modeling
- Equipment ROI evaluation before you buy
- Expansion and second-location feasibility
- Vendor and bookkeeper coordination
Real example: Equipment purchase
Before buying a $150k+ skin tightening device, we ran a full ROI analysis — not just the tax deduction. The practice made a confident purchase decision based on patient volume projections, not tax panic.
A deduction on a bad purchase is still a bad purchase. We help you see the full picture.
Tax Preparation
Accurate, timely, well-documented tax preparation. We proactively flag planning opportunities during prep — not after the return is filed.
- Business entity returns (1120-S, 1065, etc.)
- Individual returns coordinated with business filing
- Clean workpapers and documentation
- Proactive identification of planning opportunities
- Extension management when needed
- Prior-year comparison and trend analysis
More than just filing
Tax prep should be the starting point for next year's strategy, not just a compliance exercise. During preparation, we identify retirement account gaps, missed deductions, and structural improvements.
A good preparer looks forward, not just backward.
Bookkeeping
Consistent monthly close process producing clean financial statements. Your books become the foundation for every tax and business decision.
- Monthly close with consistent timeline
- Clean P&L and Balance Sheet every month
- Healthcare-specific chart of accounts
- Bank and credit card reconciliation
- Insurance reimbursement tracking
- Payroll reconciliation and provider comp tracking
Built on QuickBooks Online
We use QuickBooks Online with Keeper for smart categorization. For practices that need a fresh start, Digits offers an independent ledger option.
Either way, you get books that are closed on time, accurate, and structured to support tax planning and financial decisions — not just compliance.
Common Engagement Structures
Most practices benefit from combining services. Here are the most common ways clients work with us.
Compliance + Clarity
Clean books and accurate filing
- Monthly bookkeeping
- Annual tax preparation
- Basic planning conversations
- Clean financial statements
Proactive Owner Plan
Full financial visibility + strategy
- Everything in Compliance + Clarity
- Proactive tax planning
- Quarterly projections
- Strategy calls
Full Financial Oversight
CFO-level partnership
- Everything in Proactive Owner
- Monthly KPI reporting
- Cash flow management
- Decision support on demand
Frequently Asked Questions
Do you only work with medical practices?
My primary focus is independent medical practices with 1-5 providers. That said, the financial principles (clean books, proactive tax planning, KPI tracking) apply broadly. If you're a small professional practice and the approach resonates, let's talk.
What makes you different from a regular CPA?
I operate inside a healthcare practice day-to-day. The frameworks, KPIs, and rhythms I share come from real monthly closes — not textbooks. I understand EHR exports, insurance reimbursement timing, provider compensation modeling, and the operational reality of running a practice. Most CPAs don't.
Do I need all of these services?
No. We'll figure out what you actually need during the discovery call. Some practices start with just tax prep and planning. Others want the full financial oversight package from day one. There's no pressure to sign up for everything.
How do you handle communication?
Fewer messages, higher quality. You won't get buried in emails. We establish a clear cadence (monthly or quarterly) and keep action items specific. When you have a question between calls, you have direct access — no junior staff, no phone tree.
Can you work with my existing bookkeeper?
Absolutely. If you already have a bookkeeper and they're doing good work, I can layer tax planning and advisory on top. If your books need cleanup first, we can handle that too.
What's the typical engagement length?
Financial Oversight (CFO-lite) is a 12-month commitment because building financial rhythm takes consistency. Tax planning and preparation are annual. Bookkeeping is ongoing. We're looking for long-term partnerships, not one-off projects.
Ready to Get Started?
Schedule a 30-minute discovery call. We'll discuss your practice, your current setup, and figure out the right fit.
Schedule a Call