Medical practice bookkeeping in San Diego

Practices that need this

Independent practices across the county: a family dentist in La Mesa, a physical therapy clinic in Carlsbad, a group of therapists in Hillcrest, a med spa in Del Mar, an optometrist in Chula Vista. The owner trained to treat patients, not to read a balance sheet. The practice software handles scheduling and billing. The accounting file is often an afterthought.

Why practice income is hard to read

A single insurance deposit can cover dozens of visits across several weeks, minus adjustments and takebacks. Patient copays come through the card terminal. Patient financing companies pay in batches, net of their fee. HSA and FSA cards settle on a different schedule again.

If each deposit is just labeled income, you cannot tell if a payer cut its rates, if a takeback was ever recovered, or if card fees went up. Matching deposits to the practice system's reports fixes that.

What the books track

• Insurance payments, patient payments and financing payouts as separate income lines
• Deposits matched each month to the practice management system's deposit or payment report
• Patient refunds and overpayments recorded against income, not as expenses
• Payroll booked by clinical staff, front desk and owner, with taxes and benefits split out
• Dental lab, medical supply and pharmacy costs on their own lines
• Equipment such as chairs, imaging and lasers recorded as assets with their loans or leases
• Owner draws or distributions kept apart from practice expenses

Patient privacy and what to send

Bookkeeping does not need clinical records. The work runs on deposit summaries, payment reports by payer, bank and card statements and payroll reports. Ask your practice software for reports that show totals by payer and date, without patient names or diagnoses.

If a report must include patient detail, the bookkeeper flags it and asks for a summary version instead, so health information stays out of the accounting file.

Equipment, buildouts and loans

New practices often finance a buildout, an imaging system or a full set of operatory chairs. Expensing all of it in one month makes the first year look like a disaster and confuses your CPA. Recording the asset, the loan and each payment's split between principal and interest gives a true monthly profit and a clean depreciation schedule for tax time.

Inside the City of San Diego, practices also need a Business Tax Certificate from the City Treasurer. It is a small cost, but it belongs in the books with the right date.

How the monthly work runs

1. Collect Bank and card feeds, deposit reports from the practice system, payroll and loan statements come in.
2. Match Each deposit is matched to its source: insurance, patient card, financing or HSA.
3. Reconcile Bank, card and loan balances are tied to month-end statements.
4. Report You get a P&L with income by payer type, a balance sheet and a short list of open questions.

Signs your practice books need work

• All deposits are coded to one income account
• Patient refunds show up as office expenses
• The new X-ray unit was expensed in full
• The owner's car, phone and payroll are mixed into overhead
• Nobody reconciles the financing company's payouts

Where we work

We keep books for businesses across the City of San Diego, North County, the South Bay and East County.

• Carlsbad
• Chula Vista
• Downtown San Diego
• El Cajon
• Encinitas
• Escondido
• La Mesa
• Oceanside
• San Diego
• San Marcos
• Vista

Questions