Independent Physician & Surgical Practices
Physician-owned practices where insurance payments arrive late and adjusted, provider pay depends on production, and the owner is a high earner.
A Practice Is Also a Business
There are about 197,000 physician practices in the United States, and only around 70,000 of them are still owned by physicians. Most of the independent ones are small, with one to ten providers. The physician who owns the practice usually sees a full schedule of patients and then deals with the business side in whatever time is left. That often means late at night or on the weekend.
Our Chief Information Officer, Marc Eastin, is a practicing neurosurgeon who also owns a business. He knows what it’s like to finish a long day in clinic or the operating room and then face a stack of reports you haven’t had time to read. That experience shapes how we work with physician practices. We keep the books accurate, ask for as little of your time as we can, and tell you clearly when something needs your attention.
Who This Covers
Who This Covers
Primary care, pediatrics, OB/GYN, general and specialty surgery, dermatology, pain management, anesthesia groups, podiatry, and urgent care. Physician-owned practices anywhere in the country, from a solo doctor to a group of ten or more providers.
What Makes It Different
What Makes It Different
Revenue that arrives weeks after the visit, from many different payers, often for less than what was billed. Providers paid on production. A separate company that owns the building. Owners who earn enough that every tax decision carries real weight. Each of these needs more care than a typical small business gets.
What We Handle
Every month we close your books in QuickBooks Online and send you a one-page summary. If your books are months behind, we bring them current first. For practices that bill insurance, we also compare what your billing system reports as collected against what actually reached the bank. Payer deposits and patient payments get matched so the collections report and the bank statement tell the same story.
If your providers are paid on production, we calculate their pay each month using the compensation agreements you already have and the production reports your billing team sends us. Then we run the payroll through Gusto. We only do the math. We don’t design compensation plans or advise on how physicians should be paid, because that area falls under Stark Law and other compliance rules that belong with your healthcare attorney. If you own your building through a separate company, we keep separate books for it. And each year we put together a tax plan for you as the owner.
Monthly Books and Collections Check
Monthly Books and Collections Check
Books closed every month with a short summary you can read in a few minutes. Collections from your billing system checked against actual bank deposits. Gaps flagged while they’re recent and still easy to trace. Catch-up work done first if you’ve fallen behind.
Provider Pay Calculations
Provider Pay Calculations
Partner and provider pay calculated from your existing agreements and your billing team’s production reports. The same method every month, with the numbers laid out so each provider can see how their pay was reached. Payroll run on schedule for providers and staff alike.
Where Practices Run Into Trouble
Many practices never compare the billing system to the bank. The collections report says $180,000 came in last month, and the owner reasonably assumes it did. But a payer may have taken back an earlier payment out of a new deposit. A check may have gone to an old address. A payment may have been posted in the billing system and never actually arrived. None of this shows up until someone lines up the two sets of numbers, and by then several months may have passed.
Provider pay is often worked out by an office manager in a spreadsheet that only one person understands. Production numbers get pulled on different dates, a formula breaks, and a partner starts asking why this month looks low. Trust between partners takes a hit even when the math turns out to be right. Meanwhile the owners are earning well and paying a large tax bill every April with no plan behind it.
The Practice and the Building Run Together
The Practice and the Building Run Together
Owning the building through its own company makes sense for a lot of practices. Problems start when the practice pays the building’s mortgage directly, rent goes unrecorded for months, or one bank account covers both. It becomes hard to tell how either company is really doing, and untangling it at tax time costs more than keeping it straight all year.
Tax Decisions Made Too Late
Tax Decisions Made Too Late
By the time a return is being prepared, most of the chances to lower the bill are gone. Business structure, a reasonable owner salary, and retirement contributions all need attention during the year. The timing of a large equipment purchase can change which year it helps. Without a plan, these choices get made by default.
What Changes
Your books close every month and you get a one-page summary you can read between patients. You know that what the billing system says was collected actually reached the bank. If it didn’t, you hear about it that month instead of at the end of the year. Provider pay is calculated the same way every month from your agreements, so partners can see the numbers, understand them, and get paid on time.
The practice and the building each have their own books, with rent recorded on schedule and nothing mixed between them. Your tax plan is set during the year, while there’s still time to act on it. Returns for the practice and for you personally are prepared by enrolled agents, and if the IRS or a state sends a notice, they handle it. We’ve been doing tax work since 1995 and prepare around 1,000 returns a year.
Numbers You Can Rely On
Numbers You Can Rely On
Collections confirmed against the bank every month. Provider pay that partners stop questioning because the method is clear and consistent. Separate, clean books for the practice and the building. Fewer evenings spent on the business side and fewer surprises when you do look.
A Tax Bill With a Plan Behind It
A Tax Bill With a Plan Behind It
Each year we review your structure, owner pay, retirement contributions, and planned equipment purchases, and show you what each choice does to your tax bill. You make the decisions with the numbers in front of you. April becomes something you saw coming months earlier.
A Family-Run Firm Since 1995
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