Eye Care & Hearing Practices
Part medical practice, part retail store. We check insurance collections against deposits and track optical and hearing aid sales.
Two Businesses Under One Roof
An optometry or audiology practice runs two businesses out of the same office. The exam room works like any medical practice. You bill a vision plan or medical insurance, wait for payment, and write off whatever the plan won’t cover. Then the patient walks out to the optical floor and orders a pair of glasses, or sits down for a hearing aid fitting. At that point you are running a retail store with inventory, deposits, returns, and sales tax.
Most bookkeepers are comfortable with only one half of that. Someone who knows medical billing can follow an insurance remittance but treats frame inventory and lab bills as an afterthought. Someone who knows retail can count inventory and file sales tax but gets lost when a single vision plan deposit covers thirty patients. We do insurance work for independent physician practices and retail work for med spas, so both halves of your practice are familiar ground for us.
Who This Covers
Who This Covers
Independent optometry practices, multi-location optometry groups, audiology clinics, hearing aid practices, and offices that offer both eye and hearing care. We work with practices anywhere in the US from our office in Lenexa, Kansas, using QuickBooks Online and Gusto.
What Complicates It
What Complicates It
Vision plans and medical insurance paying different amounts on different schedules. Frames, lenses, and contact lenses that need to be tracked as inventory. Lab bills that arrive weeks after the sale. Deposits taken on glasses that haven’t been picked up yet. Hearing aid trial periods and returns. Bundled hearing aid prices that include years of follow-up visits. Sales tax rules for eyewear that differ from state to state.
The Exam Side
Exam income comes in from several directions at once. Routine eye exams go through vision plans. Medical eye care like glaucoma management, diabetic eye exams, and dry eye treatment gets billed to medical insurance and Medicare. Audiology testing has its own billing codes and its own payers. Each one pays a different rate on its own timeline, and the money usually lands in your bank as a lump sum covering dozens of patients, with the details sitting in a separate remittance report.
That makes it easy for money to go missing without anyone noticing. Your practice management system says a payment was collected, but nobody confirms it reached the bank. A payment gets posted to the wrong patient. A patient refund goes out and never gets recorded. As part of monthly bookkeeping, we compare the collections your billing system reports against what was actually deposited, and we track down the difference when the two don’t match. Your books are closed every month with a one-page summary, and if they are months behind, we bring them current first.
Collections Checked Against Deposits
Collections Checked Against Deposits
Every month we line up what your billing system says you collected with what hit the bank. Gaps get explained, whether the cause is an unposted check, a duplicate entry, or a deposit that landed in the wrong account. Small problems get caught in the month they happen instead of at tax time.
Exam Income by Payer
Exam Income by Payer
Using the reports from your billing system, we show how much of your exam income comes from vision plans, medical insurance, and patients paying out of pocket. That tells you how much of the practice depends on routine exams and how much comes from medical eye care, which matters when you are deciding whether to add equipment or another doctor.
The Retail Side
Optical sales look simple at the register and get complicated in the books. A vision plan pays a materials allowance and the patient pays the rest. When the plan’s own lab makes the lenses, you may only receive a dispensing fee, which needs to be recorded differently than a pair you paid your own lab to make. Patients put down a deposit when they order and pay the balance at pickup, so money comes in before the sale is finished. Lab bills show up later, remakes happen, and some frames sell in a week while others sit on the board for two years. Without careful tracking, the optical margin in your books ends up being a guess.
Hearing aids bring their own issues. The devices are expensive, the price often includes fittings and follow-up visits for years, and many states require a trial period where patients can return them. If the whole sale is counted as income on fitting day, a return wipes it out the next month, and the follow-up care you still owe never shows up anywhere. Sales tax adds another layer. Prescription eyewear is exempt in some states and taxable in others, and items like sunglasses, readers, cleaning kits, and hearing aid batteries are often taxable even where glasses are not.
Profit per Exam, Frame, and Fitting
Profit per Exam, Frame, and Fitting
We show what you actually keep on each type of sale after frame cost, lens and lab charges, device cost, and staff commissions. Some lens packages earn far more than others. Some frame lines barely cover their cost once plan discounts are applied. Deposits, prepaid hearing aid service plans, and annual contact lens supplies get tracked so income isn’t counted before it’s earned.
Sales Tax Handled State by State
Sales Tax Handled State by State
We confirm which of your products are taxable where you sell them, check that your point of sale is charging the right rate, and file returns on schedule. If you ship contact lenses or hearing aid supplies to patients in other states, we look at whether you owe tax there too and file where you do.
What Changes
You can see your practice as the two businesses it really is. Exam income, optical sales, and hearing aid sales each show their own margin, so you know whether the optical is pulling its weight or just staying busy. You can tell which frame lines earn their spot on the board, which vision plans pay enough to justify staying in network, and whether a lower-priced hearing aid line makes sense now that over-the-counter devices are on drugstore shelves. Monthly numbers stop swinging with deposits and returns, because income is recorded when it is earned.
The rest of the back office gets handled too. Payroll for optometrists, audiologists, opticians, technicians, and front desk staff runs through Gusto in any state. Tax returns for the practice and for you are prepared by enrolled agents, who also handle any IRS or state notices. Each year we build a tax plan around your business structure, your own pay, retirement contributions, and the timing of big purchases like an OCT machine, a retinal camera, or a sound booth. The goal is to plan ahead instead of finding out what you owe in April.
A Clear Read on Each Side
A Clear Read on Each Side
A one-page summary every month showing exam, optical, and hearing income separately, with insurance collections already checked against the bank. Decisions about staffing the optical, adding a frame line, or expanding hearing services get made from real numbers.
Fewer Surprises at Tax Time
Fewer Surprises at Tax Time
Sales tax filed on schedule in every state that applies. Quarterly estimates based on how the practice is actually doing this year. Equipment purchases timed with the tax bill in mind. A team that knows your practice and looks for savings before the year ends, not after.
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