Bookkeeping for Therapists
& Private Practice Owners
How do you know if you’re getting all the deductions your therapy practice is entitled to receive?
If the bookkeeping side of your practice has become another thing keeping you up at night, you’re in good company (with most of your colleagues). But good for you for taking the first step to fix it.
We take the QuickBooks, the reconciliations, and the questions about deductions off your plate entirely. As a therapy-practice specialist, we aren’t going to train you to do your own books; we’re simply going to do it for you.
Most therapists’ books fall into one of these categories
You started a private practice because you love the work, not because you wanted to become a bookkeeper. But the books still need to be done. So what typically happens is…
You’re trying to manage QuickBooks yourself, and it’s quietly stealing your nights and weekends. The EHR deposits don’t match what QB is showing. The chart of accounts looks like a bomb went off. You’re not sure your reconciliations are correct or what to do to fix them.
Or you don’t have a bookkeeping system at all. You promise yourself you’ll get to it, but there is always something more appealing. Tax season rolls around, and you hand your CPA a shoebox.
Or you have a bookkeeper, and they’re actually doing a pretty good job, but they can’t advise you about taxes. The books get done, but they don’t tell you anything useful. What’s the point??
We almost never talk to a practice owner who is happy with the way the books are being handled. For us, righting the ship is a simple process:
We talk
First we have a conversation with you, hear where you're at, and hear where you want to be.
We plan
Then we make a custom-tailored plan.
We do it for you
Then we implement that plan for you.
The key is #3. Most decent CPAs offer #1 and #2, but then try to coach you (“train you,” “empower you”) to do #3 yourself.
In our experience working with practice owners, they don’t want to do it themselves. They want it done for them, they want it done correctly, and they don’t want to have a hundred conversations about it.
Trusted by Therapists in Private Practice
“They have been fabulous for my assessment psychology practice's bookkeeping and tax needs.”
Read full review
Dr. Laura Sanders, PhD
What we deliver
When we handle your books, here’s what’s included:
- Transaction categorization in QuickBooks Online, using a custom chart of accounts built for therapy practices
- Bank and credit card reconciliations. Every single dollar is accounted for
- Quarterly financial statements. Maybe you won't even look at these, but you can sleep at night knowing that at least someone is.
- Year-end tax-ready package designed to totally remove the stress from “tax season.”
- A QuickBooks file that doesn't need to be rebuilt every January
- Your QuickBooks account is your property, but we manage it for you from beginning to end.
QuickBooks, set up for the way your practice actually runs
Most QuickBooks files we inherit from therapists have one of two problems: either they were set up using a generic small-business template, or they were set up by the practice owner from scratch and kind of messy.
A therapy practice’s chart of accounts should reflect how a therapy practice actually operates:
- Income that encompasses all sources (insurance, private pay, Zelle, PayPal, etc.)
- Cost of services broken out from overhead — supervisor fees, contractor 1099s, and biller fees don't belong on the same line as your rent
- Operating expenses categorized for tax efficiency — EHR, telehealth platforms, CEU, licensure, malpractice, professional development, and the line items the IRS actually wants to see
- Owner compensation structured correctly — especially if you're an S-Corp, where reasonable compensation and shareholder distributions need to be handled the right way
We rebuild the chart of accounts, clean up the historical data when needed, and from then on, the file stays clean.
If you’re not on QuickBooks Online, we’ll get it started for you without you having to lift a finger.
If you already have QuickBooks but it’s a mess, we’ll fix it.
Who we work with
- Solo therapy practice owners who’ve outgrown DIY bookkeeping
- Group practice owners who need clean books and clean reporting
- Practice owners who already have a bookkeeper but aren’t getting the tax guidance needed to make the service worthwhile.
- Therapists who want one firm handling bookkeeping, tax planning, and tax prep, instead of separate vendors who don’t talk to each other.
Our typical bookkeeping client is a private practice owner doing $80K–$250K a year in revenue, though we have many clients above that range too.
Flat fee. Never hourly or variable.
The bookkeeping fee is agreed upon based on the size and complexity of your practice. You know exactly what you’re paying and what you’re getting before we even start. There are no surprise invoices or hidden fees. And no reluctance to call us because you’re afraid the meter will start running.
Many CPAs bill by the hour, but we’ve noticed that practice owners feel more comfortable with flat fees.
Hourly billing rewards inefficiency on our side and creates anxiety on yours.
Flat fee aligns the incentives: we want to be efficient, you want to call or email us when you need us, and the price doesn’t change either way.
What changes when this is off your plate
You experience relief. Lots of brainpower is unlocked when you’re no longer ruminating about your messy bookkeeping. When the bookkeeping side of your practice is being handled by people who specifically know therapy practices, three things happen.
You get your evenings and weekends back
The hours that used to go into trying to figure out why SimplePractice doesn't match QuickBooks go back into your practice, your family, or your free time.
You start trusting your numbers
When you want to know whether you can afford to hire, raise rates, or take a slower summer, you look at a financial statement that's actually accurate, and you can decide quickly.
You stop bleeding money in taxes
Clean books are the precondition for real tax planning. Even the very best tax advisor can’t tell you anything without accurate books and records. But when your books are perfect, your tax strategy will follow suit.
Frequently Asked Questions
Ready to take bookkeeping off your plate?
Schedule a consultation. We’ll talk through where your books are today, what you need from a bookkeeping partner, and whether we’re the right fit.