Dental Practices
Associate pay calculated from your own agreements, separate books for the building, and a yearly tax plan for owner dentists.
The Practice
There are about 205,000 dentists in the US, and roughly three in four own their practice. That makes dentists the largest group of independent practice owners in healthcare. Most trained for clinical work and picked up the business side out of necessity. You spend the day chairside, then go home to review payroll, approve supply orders, and figure out why the bank balance doesn’t match what the schedule said you produced.
A dental practice is more complicated financially than it looks from the front desk. Insurance PPOs pay less than your fee schedule, and the difference has to be written off. Patients pay over time through financing companies or in-house plans. Associates are often paid a percentage of production or collections. Many owners also hold the building in a separate company. Each of these has to be handled correctly, and each one is easy to get wrong when the books are an afterthought.
Who This Covers
Who This Covers
General dentistry, pediatric dentistry, orthodontics, and oral surgery practices. Solo owners, owners with one or more associate dentists, and groups with more than one location. We work remotely with practices nationwide, using QuickBooks Online for the books and Gusto for payroll.
What Makes It Complicated
What Makes It Complicated
Insurance write-offs and slow claim payments. Production numbers that don’t match collections. Associate pay tied to production, collections, or lab fees. Large equipment purchases like CBCT units, intraoral scanners, and milling machines. Practice acquisition loans. A building owned by a separate entity that charges the practice rent. Hygienists, assistants, and front desk staff on different pay structures.
Associate Pay
Once a practice brings on an associate dentist, someone has to calculate that associate’s pay every pay period. In most offices that job falls to the owner or the office manager. They pull production and collection reports from the practice management software, apply the percentage from the associate’s agreement, subtract whatever share of lab fees the agreement calls for, compare the result to any daily guarantee, and enter it into payroll. It takes hours, and it invites second-guessing from both sides.
Our Provider Pay Calculations service takes that work off your desk. Your billing team sends us the production reports, we apply the terms of the compensation agreements you already have in place, and the resulting pay runs through payroll. The calculation is documented each month, so the owner and the associate can both see how the number was reached. When the math is consistent and written down, there is much less to argue about.
Following Your Agreements
Following Your Agreements
Percentage of production, percentage of collections, lab fee deductions, daily minimums, and adjustments for patient refunds or insurance takebacks. Whatever terms your agreements set, we apply them the same way every month, and the associate is paid on schedule.
What We Leave to You
What We Leave to You
We calculate pay. We don’t design compensation plans or advise on what an associate should earn. Provider compensation in healthcare is subject to compliance rules, and those decisions belong with you and your attorney. Our job is to make sure the agreements you signed are followed accurately.
Where the Numbers Go Wrong
Many dentists buy or build their office and hold it in a separate company, usually an LLC that leases the space back to the practice. It is a sound way to build equity, and it can help with taxes. It only works if the two companies stay apart. We see building mortgage payments made from the practice account, rent that was agreed to but never actually paid, and property taxes recorded in whichever books happened to be open. When the entities blend together, the lease stops looking like a real arrangement and the tax benefits get harder to defend.
The other common gap is between what the software reports and what the bank shows. Dentrix, Eaglesoft, and Open Dental all report production and collections. That collections figure is not always what reached the bank. Insurance checks get posted to the wrong patient, card batches fail to settle, and financing company payments arrive with fees already taken out. If nobody compares the two each month, small differences can build for a year before anyone notices.
Separate Books for the Building
Separate Books for the Building
Multi-Entity Bookkeeping keeps the practice and the building on their own books. Rent is recorded on both sides at the lease amount. Mortgage interest, depreciation, and property expenses stay with the building. Transfers between the two are documented, so each company can stand on its own at tax time or when a lender asks for statements.
Collections Checked Against Deposits
Collections Checked Against Deposits
Monthly Bookkeeping includes a comparison of the collections your software reports against actual bank deposits. Differences get traced and explained while they are still recent. Books are closed every month with a one-page summary, and practices that have fallen behind get caught up first.
Payroll and the Tax Bill
A dental office runs on its team. Hygienists may be paid hourly or on a share of production. Assistants and front desk staff have their own rates, overtime, and bonuses. Associates are paid from the monthly calculation. All of it runs through Gusto in any state where you have employees, with payroll tax deposits and filings taken care of. Payroll stops being something that eats into your evening.
Owner dentists are usually high earners, so decisions about structure and timing have a large effect on what you owe. We look at whether an S corporation election makes sense, what a reasonable owner salary is, how much can go into a retirement plan, when to buy that next piece of equipment, and how rent from the building entity fits in. Our enrolled agents work through these questions before the year ends, not after. The firm has prepared tax returns since 1995, and clients describe us as proactive because we plan for next year instead of only filing for the last one.
Payroll for the Whole Office
Payroll for the Whole Office
Hygienists, assistants, front desk staff, office managers, and associate dentists on one payroll. Associate pay flows in from the monthly calculation, and production bonuses are paid the way your policies spell out. Multi-state payroll is available for practices with locations or remote staff in more than one state.
A Tax Plan Built Around the Practice
A Tax Plan Built Around the Practice
A yearly plan covering business structure, owner pay, retirement contributions, and the timing of major equipment purchases. It accounts for both the practice and the building entity. Returns and quarterly estimates follow from the plan, and any IRS or state notice goes to an enrolled agent who already knows your situation.
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