Bookkeeping and Tax for Raleigh Medical Practices
Bookkeeping, payroll, and tax for independent practices, behavioral health groups, and integrative medicine clinics across Raleigh and the Triangle.
Bookkeeping and Tax for Raleigh Practices
Raleigh keeps showing up on lists of the fastest-growing metros in the country, and the healthcare side of the economy has grown right along with it. New residents need primary care doctors, therapists, and specialists. Physicians who trained at Duke or UNC are staying in the area and opening their own offices. Therapy groups that started with two clinicians now have eight. Sooner or later, each of these practices reaches the point where the owner can’t keep doing the books at night.
Baker’s has handled tax, bookkeeping, and payroll since 1995. Our home office is in Lenexa, Kansas, and our remote division works with practice owners across the country, including here in the Triangle. We provide medical practice bookkeeping and tax services for independent practices, with enrolled agents doing the work in QuickBooks Online and Gusto. You get the same people every month, and they take the time to learn how your practice runs.
Monthly Bookkeeping
Monthly Bookkeeping
Books closed every month with a one-page summary you can read in a few minutes. For practices that bill insurance, we compare what your billing system says was collected against what actually reached the bank. If your books are behind, we bring them current first.
Payroll and Clinician Pay
Payroll and Clinician Pay
Staff and provider payroll through Gusto, with North Carolina withholding and unemployment filings handled. Therapy and counseling groups can have session-based pay calculated every pay run from the agreements already in place. Clinicians who live across the state line are covered too.
Tax Returns and Planning
Tax Returns and Planning
Returns for the practice and the owner, quarterly estimates, and any IRS or North Carolina Department of Revenue notices, all handled by enrolled agents. Each year we review your structure, owner pay, retirement contributions, and equipment timing. We also look at whether North Carolina’s pass-through entity tax election makes sense for you.
Opening a New Practice
Opening a New Practice
A lot of Raleigh practices are only a year or two old. Our new practice setup service puts your entity, books, payroll, and software in place before the first patient arrives, so you aren’t rebuilding the foundation once the schedule is already full.
Raleigh Practices We Work With
Healthcare in Raleigh is anchored by WakeMed, UNC Rex, and Duke Health, but a growing share of patients now see providers who work for themselves. Independent groups near the hospital campuses, therapy practices in North Hills and Midtown, and cash-pay clinics in Cary, Apex, and Wake Forest. Many of these owners are excellent clinicians who are running a business for the first time.
We focus on the kinds of practices that keep growing here. If you’ve outgrown a part-time bookkeeper, or your current accountant doesn’t understand how a practice actually gets paid, this is the work we do every day.
Independent Physician and Surgical Practices
Independent Physician and Surgical Practices
Primary care, pediatrics, OB/GYN, dermatology, and surgical groups. We check insurance collections against deposits, calculate partner and provider pay from your existing agreements, and keep separate books when the owners also hold the building. Marc Eastin, our Chief Information Officer, is a practicing neurosurgeon, so we know the physician side firsthand.
Behavioral Health Groups
Behavioral Health Groups
Demand for counseling and psychiatric care in Wake County has outpaced the supply of clinicians, and group practices are adding providers as fast as they can hire. We support behavioral health group practices with payroll, session-based pay calculations, and hiring help. Our president, Marcella Nichols, holds a master’s in clinical psychology and spent seven years in recruiting and HR.
Direct Care and Integrative Medicine
Direct Care and Integrative Medicine
Direct primary care, concierge medicine, functional medicine, hormone and weight-loss clinics, and IV clinics. Most of the revenue comes from memberships, and many of these practices also sell supplements and retail products that carry sales tax. We keep membership income and product sales separate and file sales tax on time.
Med Spas and Aesthetic Clinics
Med Spas and Aesthetic Clinics
Med spas have opened across North Hills, Cary, and Brier Creek. We show your profit per treatment after product cost and commissions, and we track prepaid packages so revenue isn’t counted before the service is delivered. When a med spa is split into a management company and a medical entity, we keep both sets of books.
Common Questions About This Area
You're based in Kansas. Can you really serve a practice in Raleigh?
Yes. Our remote division was built for practice owners outside the Kansas City area, and the firm already has clients in nearly every state. We work with practices in Raleigh, Cary, Apex, Wake Forest, Durham, and Chapel Hill. Documents, approvals, and monthly reviews all happen online, and you work with the same team every month.
Do you handle North Carolina payroll and state taxes?
Yes. We run payroll through Gusto with North Carolina withholding and unemployment filings included, and we prepare the state returns for the practice and the owner. If some of your clinicians or staff live in Virginia, South Carolina, or anywhere else, we handle multi-state payroll too.
What does monthly bookkeeping cost?
Monthly bookkeeping runs between $500 and $1,500 per month depending on the size and complexity of the practice. If your books are behind when we start, catch-up work is billed at 75% of the monthly fee for each month we need to bring current. We give you an exact quote after a short conversation.
I'm leaving a hospital job to open my own practice. When should I reach out?
Before you open, if possible. Our New Practice Setup service covers your business structure, books, payroll, and software so everything is in place on day one. It is much easier to start clean than to untangle the first year after the fact.
Will you help us design a compensation plan for our clinicians?
No. Clinician and provider compensation is subject to Stark Law and other healthcare compliance rules, so plan design belongs with your healthcare attorney. What we do is calculate pay each pay run based on the agreements you already have, run the payroll, and make sure everyone is paid correctly and on time.
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